Provider Demographics
NPI:1992714646
Name:ENCARNACION, NORMA (MFT)
Entity type:Individual
Prefix:MS
First Name:NORMA
Middle Name:
Last Name:ENCARNACION
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 E COLORADO BLVD STE 710
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2012
Mailing Address - Country:US
Mailing Address - Phone:626-405-1433
Mailing Address - Fax:626-795-6738
Practice Address - Street 1:595 E COLORADO BLVD STE 710
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2012
Practice Address - Country:US
Practice Address - Phone:626-405-1433
Practice Address - Fax:626-795-6738
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24410106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist