Provider Demographics
NPI:1356490015
Name:MORTON, VALERIE MARIA (NP)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARIA
Last Name:MORTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 12TH CT
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4908
Mailing Address - Country:US
Mailing Address - Phone:310-546-4129
Mailing Address - Fax:310-517-4103
Practice Address - Street 1:25965 S. NORMANDIE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3416
Practice Address - Country:US
Practice Address - Phone:310-517-4107
Practice Address - Fax:310-517-4103
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208186363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner