Provider Demographics
NPI:1285744466
Name:MYERS, NORMA LEE (LMFT)
Entity type:Individual
Prefix:MS
First Name:NORMA
Middle Name:LEE
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 VINE ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-2034
Mailing Address - Country:US
Mailing Address - Phone:510-849-5455
Mailing Address - Fax:510-848-9402
Practice Address - Street 1:2040 VINE ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-2034
Practice Address - Country:US
Practice Address - Phone:510-849-5455
Practice Address - Fax:510-848-9402
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35515106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist