Healthcare Provider Details

I. General information

NPI: 1679629687
Provider Name (Legal Business Name): JULIETTE HARISPE NORMAN PT, DPT, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIETTE HARISPE

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 CONGRESS ST SUITE 303
PASADENA CA
91105-3024
US

IV. Provider business mailing address

1375 GREEN LN
LA CANADA FLINTRIDGE CA
91011-1751
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-5005
  • Fax:
Mailing address:
  • Phone: 818-281-6471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT301980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: