Provider Demographics
NPI:1275014102
Name:MORRIS, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MORRIS
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:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:CA
Mailing Address - Zip Code:93432-0150
Mailing Address - Country:US
Mailing Address - Phone:626-695-7272
Mailing Address - Fax:
Practice Address - Street 1:555 N PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-2811
Practice Address - Country:US
Practice Address - Phone:951-436-5300
Practice Address - Fax:951-436-5352
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141841106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty