Provider Demographics
NPI:1265298939
Name:NORRO, MARCELLA IVETH
Entity type:Individual
Prefix:
First Name:MARCELLA
Middle Name:IVETH
Last Name:NORRO
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 1:12398 MARMONT PL
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7415
Mailing Address - Country:US
Mailing Address - Phone:818-415-9083
Mailing Address - Fax:
Practice Address - Street 1:12398 MARMONT PL
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7415
Practice Address - Country:US
Practice Address - Phone:818-415-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool