Healthcare Provider Details

I. General information

NPI: 1912736414
Provider Name (Legal Business Name): ISABELLA ROSE MAYUGA MORRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9815 CARROLL CANYON RD
SAN DIEGO CA
92131-1123
US

IV. Provider business mailing address

9815 CARROLL CANYON RD
SAN DIEGO CA
92131-1123
US

V. Phone/Fax

Practice location:
  • Phone: 858-442-4480
  • Fax:
Mailing address:
  • Phone: 858-442-4480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: