Healthcare Provider Details
I. General information
NPI: 1497820344
Provider Name (Legal Business Name): MORGAN BRIANNA PEPITON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/22/2006
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
835 5TH AVE STE 307
SAN DIEGO CA
92101
US
IV. Provider business mailing address
PO BOX 154103
SAN DIEGO CA
92195-4103
US
V. Phone/Fax
- Phone: 858-914-1603
- Fax:
- Phone: 619-741-7558
- Fax: 619-741-7558
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0200X |
| Taxonomy | Forensic Psychologist |
| License Number | PSY23246 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY23246 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: