Healthcare Provider Details

I. General information

NPI: 1568099547
Provider Name (Legal Business Name): CHRISTINA LETICIA NORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA NOYOLA FNP

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7138 VAN NUYS BLVD
VAN NUYS CA
91405-3005
US

IV. Provider business mailing address

14624 SHERMAN WAY STE 600
VAN NUYS CA
91405-2289
US

V. Phone/Fax

Practice location:
  • Phone: 818-778-6240
  • Fax:
Mailing address:
  • Phone: 818-988-6305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95013350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: