Provider Demographics
NPI:1861671679
Name:MORRIS, LISA LUREE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LUREE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:LUREE
Other - Last Name:SURACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO. BOX 215
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS REY
Mailing Address - State:CA
Mailing Address - Zip Code:92068
Mailing Address - Country:US
Mailing Address - Phone:760-401-0151
Mailing Address - Fax:760-366-0529
Practice Address - Street 1:121 S PALM CANYON DR STE 217
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6378
Practice Address - Country:US
Practice Address - Phone:442-266-7532
Practice Address - Fax:760-366-0529
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52281106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist