Healthcare Provider Details

I. General information

NPI: 1215405642
Provider Name (Legal Business Name): JESSIKA LYNN MORRISON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2018
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5919 SARAH CT
CARMICHAEL CA
95608-5554
US

IV. Provider business mailing address

5919 SARAH CT
CARMICHAEL CA
95608-5554
US

V. Phone/Fax

Practice location:
  • Phone: 916-382-2606
  • Fax:
Mailing address:
  • Phone: 916-382-2606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number123812
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: