Provider Demographics
NPI:1700602034
Name:WEBER, MORGAN ROSE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ROSE
Last Name:WEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W REDONDO BEACH BLVD APT 105
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-4846
Mailing Address - Country:US
Mailing Address - Phone:209-658-7446
Mailing Address - Fax:
Practice Address - Street 1:2501 W REDONDO BEACH BLVD APT 105
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-4846
Practice Address - Country:US
Practice Address - Phone:209-658-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula