Healthcare Provider Details

I. General information

NPI: 1912190869
Provider Name (Legal Business Name): HELENA HOLMES MORRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HELENA MORRISON SPEAKE L.C.S.W.

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2068A E. MISSION RD.
FALLBROOK CA
92028
US

IV. Provider business mailing address

PO BOX 1515
FALLBROOK CA
92088-1515
US

V. Phone/Fax

Practice location:
  • Phone: 760-580-8300
  • Fax:
Mailing address:
  • Phone: 760-580-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS13124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: