Provider Demographics
NPI:1992388680
Name:MORSE, SHANA
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:MORSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18719 CALVERT ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6812
Mailing Address - Country:US
Mailing Address - Phone:818-798-3201
Mailing Address - Fax:747-225-0696
Practice Address - Street 1:18719 CALVERT ST
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91335-6812
Practice Address - Country:US
Practice Address - Phone:818-798-3201
Practice Address - Fax:747-225-0696
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist