Healthcare Provider Details

I. General information

NPI: 1033771530
Provider Name (Legal Business Name): NORMA VISAGIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WOOD ST
EUREKA CA
95501-4413
US

IV. Provider business mailing address

720 WOOD ST
EUREKA CA
95501-4413
US

V. Phone/Fax

Practice location:
  • Phone: 702-268-2990
  • Fax:
Mailing address:
  • Phone: 707-268-2990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number637497
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: