Provider Demographics
NPI:1548581036
Name:NORTON, JENIFER JO (LMT)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:JO
Last Name:NORTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9474 KEARNY VILLA RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126
Mailing Address - Country:US
Mailing Address - Phone:858-578-2070
Mailing Address - Fax:858-578-2722
Practice Address - Street 1:9474 KEARNY VILLA RD
Practice Address - Street 2:SUITE 113
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4595
Practice Address - Country:US
Practice Address - Phone:858-578-2070
Practice Address - Fax:858-578-2722
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2859225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist