Provider Demographics
NPI:1891274635
Name:MORRIS CLINIC INC
Entity Type:Organization
Organization Name:MORRIS CLINIC INC
Other - Org Name:MORRIS CLINIC INC
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:661-951-4662
Mailing Address - Street 1:1672 W AVENUE J STE 207
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2861
Mailing Address - Country:US
Mailing Address - Phone:661-951-4662
Mailing Address - Fax:
Practice Address - Street 1:1672 W AVENUE J STE 207
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2861
Practice Address - Country:US
Practice Address - Phone:661-951-4662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18567261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790860732OtherNPI