Provider Demographics
NPI:1013926674
Name:MORRISON, FREDERIC (MFT)
Entity Type:Individual
Prefix:MR
First Name:FREDERIC
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39803 PASEO PADRE PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2992
Mailing Address - Country:US
Mailing Address - Phone:510-435-5326
Mailing Address - Fax:510-244-4787
Practice Address - Street 1:39803 PASEO PADRE PKWY STE C
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2992
Practice Address - Country:US
Practice Address - Phone:510-435-5326
Practice Address - Fax:510-244-4787
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20953106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist