Healthcare Provider Details

I. General information

NPI: 1073199543
Provider Name (Legal Business Name): MELISSA LYNNE MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 COAST VILLAGE RD
SANTA BARBARA CA
93108-2733
US

IV. Provider business mailing address

136 E SOLA ST
SANTA BARBARA CA
93101-1926
US

V. Phone/Fax

Practice location:
  • Phone: 805-253-3623
  • Fax:
Mailing address:
  • Phone: 805-898-4018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number071.007481
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY24541
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: