Provider Demographics
NPI:1831715242
Name:NOELLE, KALINA COLLEEN A (PSYD)
Entity type:Individual
Prefix:DR
First Name:KALINA
Middle Name:COLLEEN A
Last Name:NOELLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:COLLEEN
Other - Middle Name:N
Other - Last Name:RADU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:955 DEEP VALLEY DR UNIT 2411
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3026
Mailing Address - Country:US
Mailing Address - Phone:424-262-8388
Mailing Address - Fax:
Practice Address - Street 1:955 DEEP VALLEY DR UNIT 2411
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3026
Practice Address - Country:US
Practice Address - Phone:424-262-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34914103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical