Provider Demographics
NPI:1356510754
Name:BRENDA L. MORELOS LMFT
Entity type:Organization
Organization Name:BRENDA L. MORELOS LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MORELOS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-979-6115
Mailing Address - Street 1:25 CADILLAC DR STE 105
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-8350
Mailing Address - Country:US
Mailing Address - Phone:916-979-6115
Mailing Address - Fax:916-489-8184
Practice Address - Street 1:25 CADILLAC DR STE 105
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-8350
Practice Address - Country:US
Practice Address - Phone:916-979-6115
Practice Address - Fax:916-489-8184
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORELOS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36716106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty