Healthcare Provider Details
I. General information
NPI: 1235293895
Provider Name (Legal Business Name): EILEEN K NORTON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/20/2006
Last Update Date: 10/19/2024
Certification Date: 10/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 GATEWAY DR, #1288 #1288
LINCOLN CA
95648-9564
US
IV. Provider business mailing address
200 GATEWAY DR UNIT 1288
LINCOLN CA
95648-7052
US
V. Phone/Fax
- Phone: 916-354-5547
- Fax:
- Phone: 916-354-5547
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PSY19240 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | PSY19240 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY19240 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: