Healthcare Provider Details

I. General information

NPI: 1164857165
Provider Name (Legal Business Name): PEGGY DANIELLE NORWOOD LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2013
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WILSHIRE BLVD STE 204
SANTA MONICA CA
90401-1737
US

IV. Provider business mailing address

720 WILSHIRE BLVD STE 204
SANTA MONICA CA
90401-1737
US

V. Phone/Fax

Practice location:
  • Phone: 626-344-2921
  • Fax:
Mailing address:
  • Phone: 626-344-2921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT109809
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83039
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMF83039
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF83039
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: