Provider Demographics
NPI:1619643376
Name:NORRIS, LOURDES ELIZABETH (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:ELIZABETH
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MS
Other - First Name:LOURDES
Other - Middle Name:ELIZABETH
Other - Last Name:ARREOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1601 W MACARTHUR BLVD APT 31A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-8234
Mailing Address - Country:US
Mailing Address - Phone:714-724-5880
Mailing Address - Fax:
Practice Address - Street 1:1601 W MACARTHUR BLVD APT 31A
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-8234
Practice Address - Country:US
Practice Address - Phone:714-724-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty