Provider Demographics
NPI:1710476353
Name:NORRIS, BRIANNA LYNN
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
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 1:2529 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3508
Mailing Address - Country:US
Mailing Address - Phone:650-834-2054
Mailing Address - Fax:
Practice Address - Street 1:640 W 2ND ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1270
Practice Address - Country:US
Practice Address - Phone:650-834-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician