Provider Demographics
NPI:1821517780
Name:NOVOA, COURTNEY (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:NOVOA
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:HOLZHAUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:101 E REDLANDS BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4723
Mailing Address - Country:US
Mailing Address - Phone:909-792-8866
Mailing Address - Fax:909-792-9395
Practice Address - Street 1:101 E REDLANDS BLVD STE 106
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4723
Practice Address - Country:US
Practice Address - Phone:909-792-8866
Practice Address - Fax:909-792-9395
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007094363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics