Healthcare Provider Details

I. General information

NPI: 1033959093
Provider Name (Legal Business Name): ANASTASIA MORRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 SOLACE PL STE D2
MOUNTAIN VIEW CA
94040-4337
US

IV. Provider business mailing address

1 WILMINGTON ACRES CT
EMERALD HILLS CA
94062-4052
US

V. Phone/Fax

Practice location:
  • Phone: 650-646-5912
  • Fax:
Mailing address:
  • Phone: 650-255-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: