Provider Demographics
NPI:1104202639
Name:FELTON, MORGAN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:FELTON
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 1:2270 CAHUILLA ST
Mailing Address - Street 2:APT 201
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-4707
Mailing Address - Country:US
Mailing Address - Phone:909-855-0293
Mailing Address - Fax:
Practice Address - Street 1:1370 S STATE ST
Practice Address - Street 2:SUITE B
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-4933
Practice Address - Country:US
Practice Address - Phone:951-791-3596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst