Individual
MR. NOAH SETH BONNEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
4633 OLD IRONSIDES DR STE 304, SANTA CLARA, CA 95054-1846
(323) 205-7088
Mailing address
4633 OLD IRONSIDES DR STE 304, SANTA CLARA, CA 95054-1846
(323) 205-7088
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
363L00000X
Nurse Practitioner
95021678
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95021678
CA
Other
Enumeration date
03/06/2007
Last updated
06/27/2025
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