Provider Demographics
NPI:1225671217
Name:MORGNER, SONJA URSULA (CMT, CLT, CST-T)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:URSULA
Last Name:MORGNER
Suffix:
Gender:F
Credentials:CMT, CLT, CST-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 SARATOGA AVE BLDG 5A
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-6613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1848 SARATOGA AVE BLDG 5A
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-6613
Practice Address - Country:US
Practice Address - Phone:408-354-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4500OtherCALIFORNIA STATE BOARD OF MASSAGE THERAPIST