Provider Demographics
NPI:1609173194
Name:FRED MORRISON, MFT
Entity Type:Organization
Organization Name:FRED MORRISON, MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:510-435-5326
Mailing Address - Street 1:39803 PASEO PADRE PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2992
Mailing Address - Country:US
Mailing Address - Phone:510-435-5326
Mailing Address - Fax:510-244-4787
Practice Address - Street 1:39803 PASEO PADRE PKWY STE C
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2992
Practice Address - Country:US
Practice Address - Phone:510-435-5326
Practice Address - Fax:510-244-4787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20953261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)