Healthcare Provider Details

I. General information

NPI: 1841666161
Provider Name (Legal Business Name): BETHANY NICOLE NORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8912 VOLUNTEER LN
SACRAMENTO CA
95826-3221
US

IV. Provider business mailing address

8912 VOLUNTEER LN
SACRAMENTO CA
95826-3221
US

V. Phone/Fax

Practice location:
  • Phone: 916-344-0199
  • Fax: 916-344-0196
Mailing address:
  • Phone: 916-344-0199
  • Fax: 916-344-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: