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General NPI Number Information
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NPI Number | 1740347699
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Entity Type | Individual
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Provider Name | ANNA KANAKO MORITA PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 975 SERENO DR 3RD FLOOR
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City | VALLEJO
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State | CA
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Zip | 94589-2441
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Country | US
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Telephone | 707-651-4142
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Fax | 707-651-4160
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Provider Business Mailing Address
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Address Line | 925 ARLINGTON BLVD
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City | EL CERRITO
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State | CA
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Zip | 94530-2703
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Country | US
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Telephone | 707-651-4142
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Fax | 707-651-4160
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY19562
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License Number State | CA
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