Provider Demographics
NPI:1124699228
Name:MORRIS, ALYSSA RAE (MA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:RAE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 11TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4668
Mailing Address - Country:US
Mailing Address - Phone:262-573-9845
Mailing Address - Fax:
Practice Address - Street 1:3250 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1577
Practice Address - Country:US
Practice Address - Phone:323-361-2956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program