Provider Demographics
NPI:1710264619
Name:MORSE, SARAH (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MORSE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26382 CORTINA DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5423
Mailing Address - Country:US
Mailing Address - Phone:949-290-2634
Mailing Address - Fax:
Practice Address - Street 1:2100 POWELL ST
Practice Address - Street 2:SUITE 900
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1826
Practice Address - Country:US
Practice Address - Phone:510-350-2600
Practice Address - Fax:510-879-9084
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21984363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant