Provider Demographics
NPI:1144037375
Name:NORGREN, VICTORIA ELISE
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ELISE
Last Name:NORGREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 J ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3055
Mailing Address - Country:US
Mailing Address - Phone:951-956-1468
Mailing Address - Fax:
Practice Address - Street 1:2100 J ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3055
Practice Address - Country:US
Practice Address - Phone:951-956-1468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health