Provider Demographics
NPI:1144456831
Name:NORRIS, JANE A (LMFT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6809 INDIANA AVE STE 137
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4221
Mailing Address - Country:US
Mailing Address - Phone:714-390-9893
Mailing Address - Fax:714-390-9893
Practice Address - Street 1:6809 INDIANA AVE STE 137
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4221
Practice Address - Country:US
Practice Address - Phone:714-390-9893
Practice Address - Fax:303-568-6022
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN6494547106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist