Individual ProviderLacey NoonanMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address5435 College Ave Ste 202-7, Oakland, CA 94618-1598(619) 729-2395PECOS EnrollmentBased on the most recent information from CMS, provider Lacey Noonan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1083901318Provider TypeIndividualFull NameNoonan, LaceyCredentialM.F.T., N.C.C.GenderFemaleSole ProprietorYesEnumeration Date7/7/2011Last Updated2/13/2017Contact InformationPractice LocationPractice Address5435 College Ave Ste 202-7, Oakland, CA 94618-1598Phone(619) 729-2395Fax(619) 729-2395Mailing LocationMailing Address5435 College Ave Ste 202-7, Oakland, CA 94618-1598Phone(619) 729-2395Fax(619) 729-2395Provider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC 50196California