Provider Demographics
NPI:1124991591
Name:MORGAN, DONISHA EVETTE
Entity type:Individual
Prefix:
First Name:DONISHA
Middle Name:EVETTE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14090 PADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-7427
Mailing Address - Country:US
Mailing Address - Phone:760-905-9766
Mailing Address - Fax:
Practice Address - Street 1:17508 HERCULES ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-7600
Practice Address - Country:US
Practice Address - Phone:760-488-7971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker