Healthcare Provider Details

I. General information

NPI: 1881776375
Provider Name (Legal Business Name): JEANNE LOUISE MORRIS R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W MAIN ST KAWEAH DELTA OUTPATIENT SPECIALTY CLINCS
VISALIA CA
93291-6240
US

IV. Provider business mailing address

400 W MINERAL KING AVE OUTPATIENT SPECIALTY CLINICS
VISALIA CA
93291-6237
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-2892
  • Fax: 559-635-4057
Mailing address:
  • Phone: 559-624-2892
  • Fax: 559-635-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: