Provider Demographics
NPI:1518064690
Name:MORRIS, DESDA MARIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DESDA
Middle Name:MARIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 S HIGUERA ST
Mailing Address - Street 2:#113
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:805-545-8892
Mailing Address - Fax:805-545-8892
Practice Address - Street 1:1190 MARSH ST
Practice Address - Street 2:SUITE G
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-545-8892
Practice Address - Fax:805-545-8892
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24050106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist