Provider Demographics
NPI:1578348413
Name:NORIA, JANNETTE
Entity Type:Individual
Prefix:
First Name:JANNETTE
Middle Name:
Last Name:NORIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANNETTE
Other - Middle Name:
Other - Last Name:NORIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 E 2ND ST STE 105
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-2843
Mailing Address - Country:US
Mailing Address - Phone:760-408-0685
Mailing Address - Fax:
Practice Address - Street 1:416 E 2ND ST STE 105
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-2843
Practice Address - Country:US
Practice Address - Phone:760-408-0685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB7384283343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)