Basic Information
Provider Information
NPI: 1386764314
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NORWITZ
FirstName: LEONARD
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: L.C.S.W.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 259 N CAPITOL AVE
Address2: #113
City: SAN JOSE
State: CA
PostalCode: 951272377
CountryCode: US
TelephoneNumber: 4082583023
FaxNumber:  
Practice Location
Address1: 2001 THE ALAMEDA
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951261136
CountryCode: US
TelephoneNumber: 4082617777
FaxNumber: 4082549960
Other Information
ProviderEnumerationDate: 03/31/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XLCS 9532CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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