Individual
JACINDA DANIELLE NORVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 KEYSTONE DR, SAN BERNARDINO, CA 92407-5024
(909) 712-9559
Mailing address
1408 KEYSTONE DR, SAN BERNARDINO, CA 92407-5024
(909) 712-9559
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22
—
CA
Enumeration date
07/27/2023
Last updated
07/27/2023
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