Provider Demographics
NPI:1720246754
Name:MORSE, ROXANNE NONE (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:NONE
Last Name:MORSE
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3871 PIEDMONT AVE # 81
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5378
Mailing Address - Country:US
Mailing Address - Phone:510-697-3231
Mailing Address - Fax:510-842-3387
Practice Address - Street 1:445 BELLEVUE AVE STE 101
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4923
Practice Address - Country:US
Practice Address - Phone:510-697-3231
Practice Address - Fax:510-842-3287
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16898103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist