MEDICARE: JANE A NORRIS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	N6494547	CA

General Provider Information

NPI Number	:	1144456831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE A NORRIS LMFT

Provider Business Mailing Address
First Line	:	6809 INDIANA AVE STE 137
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-4221
Country	:	US
Telephone Number	:	714-390-9893
Fax Number	:	714-390-9893

Provider Business Practice Location Address
First Line	:	6809 INDIANA AVE STE 137
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-4221
Country	:	US
Telephone Number	:	714-390-9893
Fax Number	:	303-568-6022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	10/02/2019

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