Provider Demographics
NPI:1023168150
Name:NORTON, BEVERLY A (PSYD)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:A
Last Name:NORTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:BEVERLY
Other - Middle Name:A
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 1376
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640-1376
Mailing Address - Country:US
Mailing Address - Phone:707-575-4831
Mailing Address - Fax:
Practice Address - Street 1:293 RAILROAD FLAT RD
Practice Address - Street 2:
Practice Address - City:MOKELUMNE HILL
Practice Address - State:CA
Practice Address - Zip Code:95245
Practice Address - Country:US
Practice Address - Phone:707-480-4831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22268103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical