Provider Demographics
NPI:1063697647
Name:CAFFE, B. NOELLE (MA, MFT)
Entity type:Individual
Prefix:
First Name:B. NOELLE
Middle Name:
Last Name:CAFFE
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4447 PENNIMAN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-2682
Mailing Address - Country:US
Mailing Address - Phone:510-919-8854
Mailing Address - Fax:
Practice Address - Street 1:4445 PENNIMAN AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-2682
Practice Address - Country:US
Practice Address - Phone:510-919-8854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46884106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist