Provider Demographics
NPI:1508384199
Name:MORTON, SYLVIA JEAN
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:JEAN
Last Name:MORTON
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 1:15025 MT WILSON LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5351
Mailing Address - Country:US
Mailing Address - Phone:909-512-2987
Mailing Address - Fax:909-463-9222
Practice Address - Street 1:3300 IRVINE AVE STE 307
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3108
Practice Address - Country:US
Practice Address - Phone:949-724-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2017-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN419176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse