Provider Demographics
NPI:1982734935
Name:MARCUCCI-MORRIS, ILANA VERA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ILANA
Middle Name:VERA
Last Name:MARCUCCI-MORRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ILANA
Other - Middle Name:V
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2398 CROYDEN PL
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-6076
Mailing Address - Country:US
Mailing Address - Phone:858-344-7585
Mailing Address - Fax:
Practice Address - Street 1:2401 MERCED ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4228
Practice Address - Country:US
Practice Address - Phone:858-344-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA700431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical