1164763561 NPI number — MRS. CHRISTINA RENEE NORWOOD MTP, OCS

Table of content: MRS. CHRISTINA RENEE NORWOOD MTP, OCS (NPI 1164763561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164763561 NPI number — MRS. CHRISTINA RENEE NORWOOD MTP, OCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORWOOD
Provider First Name:
CHRISTINA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MTP, OCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164763561
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2696 S COLORADO BLVD
Provider Second Line Business Mailing Address:
SUITE 420
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-615-2453
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3468 MT DIABLO BLVD
Provider Second Line Business Practice Location Address:
B110
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94549-3957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-284-6150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/09/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  39928 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 0015219 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com