Healthcare Provider Details
I. General information
NPI: 1093029100
Provider Name (Legal Business Name): DANIA MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/30/2010
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2550 E FOOTHILL BLVD
PASADENA CA
91107-3406
US
IV. Provider business mailing address
1023 KATELLA ST
LAGUNA BEACH CA
92651-3519
US
V. Phone/Fax
- Phone: 626-744-5230
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | 22436 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: