Healthcare Provider Details

I. General information

NPI: 1912019639
Provider Name (Legal Business Name): RONALD DEAN MORGAN ED.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 CORONA MALL
CORONA CA
92879-1420
US

IV. Provider business mailing address

715 ORANGE HILL DR
CORONA CA
92881-3548
US

V. Phone/Fax

Practice location:
  • Phone: 951-279-5905
  • Fax: 951-279-5905
Mailing address:
  • Phone: 951-279-5905
  • Fax: 951-279-5905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY 12109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: