Healthcare Provider Details

I. General information

NPI: 1811223654
Provider Name (Legal Business Name): ELIZABETH A. MORGAN F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH SODERBERG-HARRIS F.N.P.

II. Dates (important events)

Enumeration Date: 10/29/2009
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 E. BETTERAVIA ROAD SUITE C
SANTA MARIA CA
93454
US

IV. Provider business mailing address

340 E. BETTERAVIA ROAD SUITE C
SANTA MARIA CA
93454
US

V. Phone/Fax

Practice location:
  • Phone: 805-922-0561
  • Fax: 805-922-0083
Mailing address:
  • Phone: 805-922-0561
  • Fax: 805-922-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10112
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: