Provider Demographics
NPI:1912019639
Name:MORGAN, RONALD DEAN (EDD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DEAN
Last Name:MORGAN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 ORANGE HILL DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3548
Mailing Address - Country:US
Mailing Address - Phone:951-279-5905
Mailing Address - Fax:951-279-5905
Practice Address - Street 1:522 CORONA MALL
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1420
Practice Address - Country:US
Practice Address - Phone:951-279-5905
Practice Address - Fax:951-279-5905
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 12109103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33BE1PMedicaid
CA33BE1PMedicaid