Provider Demographics
NPI:1649782905
Name:MORRIS, OLGA
Entity type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:OLGA
Other - Middle Name:MICHELLE
Other - Last Name:MORRIS GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8236 SHERWOOD PL
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3440
Mailing Address - Country:US
Mailing Address - Phone:949-310-2413
Mailing Address - Fax:
Practice Address - Street 1:8236 SHERWOOD PL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-3440
Practice Address - Country:US
Practice Address - Phone:949-310-2413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician