Provider Demographics
NPI:1619035185
Name:NORRIS, SHELLIE
Entity Type:Individual
Prefix:
First Name:SHELLIE
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 LEDGEVIEW PL
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-6820
Mailing Address - Country:US
Mailing Address - Phone:619-519-9035
Mailing Address - Fax:
Practice Address - Street 1:2504 LEDGEVIEW PL
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-6820
Practice Address - Country:US
Practice Address - Phone:619-519-9035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker