Provider Demographics
NPI:1679682611
Name:NOVAK, ESTHER EVE (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:EVE
Last Name:NOVAK
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:PO BOX 73795
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-3795
Mailing Address - Country:US
Mailing Address - Phone:530-753-3771
Mailing Address - Fax:530-753-3767
Practice Address - Street 1:2062 JOHN JONES RD
Practice Address - Street 2:SUITE 120
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-9707
Practice Address - Country:US
Practice Address - Phone:530-753-3771
Practice Address - Fax:530-753-3767
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG431932084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G431930Medicaid
CAA49264Medicare UPIN
CA00G431930Medicare ID - Type Unspecified