Provider Demographics
NPI:1407556756
Name:NORTON, EVA (ACSW)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:NORTON
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34185 STREET OF THE VIOLET LANTERN
Mailing Address - Street 2:STE 103
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629
Mailing Address - Country:US
Mailing Address - Phone:612-965-7819
Mailing Address - Fax:
Practice Address - Street 1:34185 STREET OF THE VIOLET LANTERN
Practice Address - Street 2:STE 103
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629
Practice Address - Country:US
Practice Address - Phone:612-965-7819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106287104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker