Provider Demographics
NPI:1700862372
Name:NOORT, JANICE M (NP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:NOORT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 V ST
Mailing Address - Street 2:PSSB-SUITE 3400, MED: INTERNAL MED/PUL/HOSPITAL MED
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-7506
Mailing Address - Fax:916-734-7924
Practice Address - Street 1:4150 V ST STE 3400
Practice Address - Street 2:PSSB-SUITE 1200, MED: INTERNAL MED/PUL/HOSPITAL MED
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-7506
Practice Address - Fax:916-734-7924
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA632667/15593 RN/NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA009568OtherPHYSICIAN INDEX #
CA009568OtherPHYSICIAN INDEX #