Provider Demographics
NPI:1528333457
Name:MORLEY, ANTOINETTE T (MFT)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:T
Last Name:MORLEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:ANTOINETTE
Other - Middle Name:T
Other - Last Name:MORLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:11062 CANYON VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5405
Mailing Address - Country:US
Mailing Address - Phone:408-996-2240
Mailing Address - Fax:
Practice Address - Street 1:15047 LOS GATOS BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2054
Practice Address - Country:US
Practice Address - Phone:408-364-6799
Practice Address - Fax:408-378-4510
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-10
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 30061101YP2500X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional