Provider Demographics
NPI:1508010356
Name:MORRIS, TAMILYNNE ANJANETTE
Entity Type:Individual
Prefix:MRS
First Name:TAMILYNNE
Middle Name:ANJANETTE
Last Name:MORRIS
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 1:44443 N 10TH STREET WEST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-726-2630
Mailing Address - Fax:661-952-1030
Practice Address - Street 1:44443 N 10TH STREET WEST
Practice Address - Street 2:44443 N 10TH STREET WEST
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-1411
Practice Address - Country:US
Practice Address - Phone:818-996-1051
Practice Address - Fax:818-345-3778
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARW2341101Y00000X
CARS5064324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101Y00000XBehavioral Health & Social Service ProvidersCounselor