Provider Demographics
NPI:1366817983
Name:NORMAN, JILL K (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:K
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 ALAMEDA PADRE SERRA
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2137
Mailing Address - Country:US
Mailing Address - Phone:310-650-7058
Mailing Address - Fax:
Practice Address - Street 1:22 W MICHELTORENA ST UNIT A-EAST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6522
Practice Address - Country:US
Practice Address - Phone:805-855-0957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1511422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry