Basic Information
| Provider Information | |||||||||
| NPI: | 1700862372 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOORT | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4150 V ST | ||||||||
| Address2: | PSSB-SUITE 3400, MED: INTERNAL MED/PUL/HOSPITAL MED | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167347506 | ||||||||
| FaxNumber: | 9167347924 | ||||||||
| Practice Location | |||||||||
| Address1: | 4150 V ST STE 3400 | ||||||||
| Address2: | PSSB-SUITE 1200, MED: INTERNAL MED/PUL/HOSPITAL MED | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958171460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167347506 | ||||||||
| FaxNumber: | 9167347924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2005 | ||||||||
| LastUpdateDate: | 05/03/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 632667/15593 RN/NP | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 009568 | 01 | CA | PHYSICIAN INDEX # | OTHER |