Healthcare Provider Details

I. General information

NPI: 1568398006
Provider Name (Legal Business Name): MORGAN EPPERSON JEALOUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 BROADWAY AVE
SEASIDE CA
93955-4996
US

IV. Provider business mailing address

1069 BROADWAY AVE
SEASIDE CA
93955-4996
US

V. Phone/Fax

Practice location:
  • Phone: 831-392-1500
  • Fax: 831-392-1501
Mailing address:
  • Phone: 831-392-1500
  • Fax: 831-392-1501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: