Provider Demographics
NPI:1932794138
Name:ECHOLS, NAOMI (LC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:LC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 BRADLEY WAY
Mailing Address - Street 2:
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-1412
Mailing Address - Country:US
Mailing Address - Phone:650-921-4942
Mailing Address - Fax:
Practice Address - Street 1:1024 BRADLEY WAY
Practice Address - Street 2:
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1412
Practice Address - Country:US
Practice Address - Phone:650-921-4942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty