Provider Demographics
NPI:1902798762
Name:DARRELL, NORA (CMT)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:DARRELL
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 E ST STE A
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-2930
Mailing Address - Country:US
Mailing Address - Phone:858-249-3865
Mailing Address - Fax:
Practice Address - Street 1:265 E ST STE A
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2930
Practice Address - Country:US
Practice Address - Phone:858-249-3865
Practice Address - Fax:858-294-4301
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68937225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist