Provider Demographics
NPI:1104702034
Name:NOOJIBAIL, PRITHVI
Entity type:Individual
Prefix:
First Name:PRITHVI
Middle Name:
Last Name:NOOJIBAIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:CA
Mailing Address - Zip Code:95953-9662
Mailing Address - Country:US
Mailing Address - Phone:408-624-0377
Mailing Address - Fax:
Practice Address - Street 1:91 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3098
Practice Address - Country:US
Practice Address - Phone:408-624-0377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider