Healthcare Provider Details

I. General information

NPI: 1154238988
Provider Name (Legal Business Name): RICHARD ORVILLE MORRISON II
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 E COLORADO BLVD
MONROVIA CA
91016-2901
US

IV. Provider business mailing address

402 W COLORADO BLVD
MONROVIA CA
91016-2647
US

V. Phone/Fax

Practice location:
  • Phone: 626-471-2380
  • Fax: 626-471-2380
Mailing address:
  • Phone: 626-471-2380
  • Fax: 626-471-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberE6888589B2
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: