Healthcare Provider Details

I. General information

NPI: 1043157001
Provider Name (Legal Business Name): MORGAN KIRK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 E ARROW HWY
UPLAND CA
91786-4982
US

IV. Provider business mailing address

1260 E ARROW HWY
UPLAND CA
91786-4982
US

V. Phone/Fax

Practice location:
  • Phone: 909-932-1069
  • Fax:
Mailing address:
  • Phone: 909-932-1069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number756490
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: