Provider Demographics
NPI:1356524482
Name:JAMES, NOELLE RENEE
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:RENEE
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:R
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19609 GREENWOOD PL N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3430
Mailing Address - Country:US
Mailing Address - Phone:559-840-9249
Mailing Address - Fax:
Practice Address - Street 1:19609 GREENWOOD PL N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3430
Practice Address - Country:US
Practice Address - Phone:559-840-9249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA258311041C0700X
CALCS 258311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker