Provider Demographics
NPI:1518214378
Name:PERRIER-MORRIS, MAXINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MAXINE
Middle Name:
Last Name:PERRIER-MORRIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:SENA
Other - Middle Name:MAXINE
Other - Last Name:PERRIER-MORRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4545 DELTA FAIR BLVD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-3950
Mailing Address - Country:US
Mailing Address - Phone:925-706-4997
Mailing Address - Fax:
Practice Address - Street 1:4545 DELTA FAIR BLVD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-3950
Practice Address - Country:US
Practice Address - Phone:925-706-4997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-12
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA326831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical