Provider Demographics
NPI:1588765697
Name:CONANT, NORICE CLARK (PHD)
Entity type:Individual
Prefix:
First Name:NORICE
Middle Name:CLARK
Last Name:CONANT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 NOE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1245
Mailing Address - Country:US
Mailing Address - Phone:415-626-0627
Mailing Address - Fax:
Practice Address - Street 1:157 NOE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1245
Practice Address - Country:US
Practice Address - Phone:415-626-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY54710174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist