Provider Demographics
NPI:1235409251
Name:MORROW, JAMES PERRY (RAS M0505101540)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PERRY
Last Name:MORROW
Suffix:
Gender:M
Credentials:RAS M0505101540
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6132
Mailing Address - Country:US
Mailing Address - Phone:310-320-8752
Mailing Address - Fax:
Practice Address - Street 1:1327 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6132
Practice Address - Country:US
Practice Address - Phone:310-320-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMO5O5101540101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA02654210Medicare PIN