Healthcare Provider Details

I. General information

NPI: 1306972526
Provider Name (Legal Business Name): EPHIMIA MORPHEW-LU C.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 WALSH AVE SUITE C2
SANTA CLARA CA
95050-2542
US

IV. Provider business mailing address

2094 WALSH AVE SUITE C2
SANTA CLARA CA
95050-2542
US

V. Phone/Fax

Practice location:
  • Phone: 650-704-6516
  • Fax: 408-567-0134
Mailing address:
  • Phone: 650-704-6516
  • Fax: 408-567-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number001170
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: