Provider Demographics
NPI:1689825150
Name:MORRIS, RAQUEL ROBINSON
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:ROBINSON
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 1:1518 W ORANGEBURG AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-3803
Mailing Address - Country:US
Mailing Address - Phone:831-295-3612
Mailing Address - Fax:
Practice Address - Street 1:126 BONIFACIO PL STE E
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2713
Practice Address - Country:US
Practice Address - Phone:831-200-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69391101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health