Provider Demographics
NPI:1700818820
Name:MORRISON, CARRIE ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ANN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3579 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4912
Mailing Address - Country:US
Mailing Address - Phone:619-291-2085
Mailing Address - Fax:619-568-3739
Practice Address - Street 1:3579 4TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4912
Practice Address - Country:US
Practice Address - Phone:619-291-2085
Practice Address - Fax:619-568-3739
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16021103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA572261Medicare UPIN
CACP16021Medicare ID - Type Unspecified