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NPI Code Detail

MEDICARE: MORGAN PEMBERTON

MEDICARE: MORGAN PEMBERTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist100464CA

General Provider Information

NPI Number : 1083279129
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN PEMBERTON
Provider Business Mailing Address
First Line : 950 S BASCOM AVE STE 2010
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-3538
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 950 S BASCOM AVE STE 2010
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-3538
Country : US
Telephone Number : 408-341-9222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2019
Last Update Date : 05/03/2019

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Directions to “ MORGAN PEMBERTON ” Practice Location

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