Individual
AVA M NOVOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
39350 CIVIC CENTER DR, SUITE # 300, FREMONT, CA 94538-2331
(228) 762-4483
(228) 769-0406
Mailing address
39350 CIVIC CENTER DR, SUITE # 300, FREMONT, CA 94538-2331
(510) 797-3933
(510) 797-5184
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1110125
NCCPA CERTIFICATION
MS
Enumeration date
08/28/2013
Last updated
01/04/2016
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