Provider Demographics
NPI:1932891637
Name:MORELL, DEVINA GUADALUPE
Entity Type:Individual
Prefix:
First Name:DEVINA
Middle Name:GUADALUPE
Last Name:MORELL
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 1:2875 FOLSOM ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4013
Mailing Address - Country:US
Mailing Address - Phone:415-815-7900
Mailing Address - Fax:
Practice Address - Street 1:9015 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3673
Practice Address - Country:US
Practice Address - Phone:140-884-2713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program