Provider Demographics
NPI:1588827984
Name:RUCCI MORRISON, KATHERINE MARY (MA)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARY
Last Name:RUCCI MORRISON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:M
Other - Last Name:RUCCI-MORRISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:6090 DEL RIO RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-1354
Mailing Address - Country:US
Mailing Address - Phone:805-458-1560
Mailing Address - Fax:
Practice Address - Street 1:625 14TH ST STE B
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446
Practice Address - Country:US
Practice Address - Phone:805-458-1560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC82976106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist