Provider Demographics
NPI:1992965099
Name:NORBERG, LAURA C JENSEN (MM, MT-BC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:C JENSEN
Last Name:NORBERG
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-2336
Mailing Address - Country:US
Mailing Address - Phone:925-817-9593
Mailing Address - Fax:
Practice Address - Street 1:110 LA CASA VIA STE 205
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-464-3916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist