Provider Demographics
NPI:1689209215
Name:MORRIS, KATHY LYNN
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:LYNN
Last Name:MORRIS
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:PO BOX 6196
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95696-6196
Mailing Address - Country:US
Mailing Address - Phone:707-317-8599
Mailing Address - Fax:
Practice Address - Street 1:470 W MONTE VISTA AVE APT C
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3735
Practice Address - Country:US
Practice Address - Phone:707-317-8599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician