Provider Demographics
NPI:1114462785
Name:ANCHONDO, NORI (CCMA-AC)
Entity Type:Individual
Prefix:
First Name:NORI
Middle Name:
Last Name:ANCHONDO
Suffix:
Gender:F
Credentials:CCMA-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 NAPA VALLEY CORPORATE DR
Mailing Address - Street 2:BUILDING A
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2751 NAPA VALLEY CORPORATE DR
Practice Address - Street 2:BUILDING A
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6216
Practice Address - Country:US
Practice Address - Phone:707-253-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACMA 13476-14171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator