Healthcare Provider Details

I. General information

NPI: 1659637858
Provider Name (Legal Business Name): LATONYA DENITA MORRIS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 E WASHINGTON BLVD STE 230
PASADENA CA
91107-1449
US

IV. Provider business mailing address

5665 WILSHIRE BLVD # 1024
LOS ANGELES CA
90036-3710
US

V. Phone/Fax

Practice location:
  • Phone: 626-296-8900
  • Fax:
Mailing address:
  • Phone: 323-855-9261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number125050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: