Provider Demographics
NPI:1942966106
Name:MORELL, JOSEPH HARMON (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:HARMON
Last Name:MORELL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2288
Mailing Address - Street 2:
Mailing Address - City:AVILA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93424-2288
Mailing Address - Country:US
Mailing Address - Phone:805-245-8008
Mailing Address - Fax:
Practice Address - Street 1:1300 E CYPRESS ST STE E
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4728
Practice Address - Country:US
Practice Address - Phone:805-361-5088
Practice Address - Fax:805-361-5079
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001619367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered