Provider Demographics
NPI:1679842850
Name:NORRIS, ANTONIA MARIE-VEGA (DPT)
Entity type:Individual
Prefix:MRS
First Name:ANTONIA
Middle Name:MARIE-VEGA
Last Name:NORRIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3468 MT DIABLO BLVD STE B110
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-7105
Mailing Address - Country:US
Mailing Address - Phone:925-284-6150
Mailing Address - Fax:925-284-6155
Practice Address - Street 1:3468 MT DIABLO BLVD
Practice Address - Street 2:SUITE B110
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3957
Practice Address - Country:US
Practice Address - Phone:925-284-6150
Practice Address - Fax:925-284-6155
Is Sole Proprietor?:No
Enumeration Date:2011-12-18
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist