Provider Demographics
NPI:1659504629
Name:MORTON, CAROLINE A (MFT, ATR-BC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:A
Last Name:MORTON
Suffix:
Gender:F
Credentials:MFT, ATR-BC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:A
Other - Last Name:DEL CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT, ATR-BC
Mailing Address - Street 1:PO BOX 678
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-0678
Mailing Address - Country:US
Mailing Address - Phone:650-455-2547
Mailing Address - Fax:
Practice Address - Street 1:131 KELLY AVE
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-1629
Practice Address - Country:US
Practice Address - Phone:650-455-2547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44169106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist