Provider Demographics
NPI:1659324101
Name:NOVESTERAS, HELENE (MD)
Entity Type:Individual
Prefix:DR
First Name:HELENE
Middle Name:
Last Name:NOVESTERAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 N BESSIE AVE
Mailing Address - Street 2:STE 106
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376
Mailing Address - Country:US
Mailing Address - Phone:209-833-3386
Mailing Address - Fax:209-835-9440
Practice Address - Street 1:1530 N BESSIE AVE
Practice Address - Street 2:STE 106
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376
Practice Address - Country:US
Practice Address - Phone:209-833-3386
Practice Address - Fax:209-835-9440
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA051250208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346586906Medicaid