Healthcare Provider Details

I. General information

NPI: 1427797398
Provider Name (Legal Business Name): BRANDON MORRISON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 S SAN PEDRO ST
LOS ANGELES CA
90013-1633
US

IV. Provider business mailing address

2116 ARLINGTON AVE # 100
LOS ANGELES CA
90018-1353
US

V. Phone/Fax

Practice location:
  • Phone: 213-537-0822
  • Fax:
Mailing address:
  • Phone: 323-334-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149315
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: