Provider Demographics
NPI:1679629687
Name:NORMAN, JULIETTE HARISPE (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:HARISPE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:JULIETTE
Other - Middle Name:
Other - Last Name:HARISPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1375 GREEN LN
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1751
Mailing Address - Country:US
Mailing Address - Phone:818-281-6471
Mailing Address - Fax:
Practice Address - Street 1:39 CONGRESS ST
Practice Address - Street 2:SUITE 303
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3024
Practice Address - Country:US
Practice Address - Phone:626-449-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT3019802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT301980OtherBLUE SHIELD INDIV #
CAPT30198OtherBLUE CROSS INDIV #
CA0PT301980OtherBLUE SHIELD INDIV #