Provider Demographics
NPI:1275164345
Name:BROOKE KIYO NORTON
Entity Type:Organization
Organization Name:BROOKE KIYO NORTON
Other - Org Name:NORTON PSYCHOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:K
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:559-690-4700
Mailing Address - Street 1:47 6TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-3092
Mailing Address - Country:US
Mailing Address - Phone:559-690-4700
Mailing Address - Fax:559-236-6077
Practice Address - Street 1:47 6TH ST STE 206
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-3092
Practice Address - Country:US
Practice Address - Phone:559-690-4700
Practice Address - Fax:559-236-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty