Provider Demographics
NPI:1649549403
Name:MORTON, AISHA CANDRIAN (MFT)
Entity type:Individual
Prefix:MS
First Name:AISHA
Middle Name:CANDRIAN
Last Name:MORTON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6847
Mailing Address - Country:US
Mailing Address - Phone:707-498-5493
Mailing Address - Fax:
Practice Address - Street 1:1470 PANORAMA DR
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6847
Practice Address - Country:US
Practice Address - Phone:707-498-5493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47668106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist