Provider Demographics
NPI:1851845614
Name:MORELOS, BRENDA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:MORELOS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CADILLAC DR STE 105
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-8350
Mailing Address - Country:US
Mailing Address - Phone:916-979-6115
Mailing Address - Fax:916-489-8184
Practice Address - Street 1:25 CADILLAC DR STE 105
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-8350
Practice Address - Country:US
Practice Address - Phone:916-979-6115
Practice Address - Fax:916-489-8184
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT36716106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist