Healthcare Provider Details

I. General information

NPI: 1528333457
Provider Name (Legal Business Name): ANTOINETTE T. MORLEY MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANTOINETTE T. MORLEY MFT

II. Dates (important events)

Enumeration Date: 03/10/2012
Last Update Date: 03/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15047 LOS GATOS BLVD STE 200
LOS GATOS CA
95032-2054
US

IV. Provider business mailing address

11062 CANYON VISTA DR
CUPERTINO CA
95014-5405
US

V. Phone/Fax

Practice location:
  • Phone: 408-364-6799
  • Fax: 408-378-4510
Mailing address:
  • Phone: 408-996-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMFT 30061
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: