MEDICARE: CRYSTAL MORRIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1255727038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL MORRIS

Provider Business Mailing Address
First Line	:	4992 UNION AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-5155
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4992 UNION AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-5155
Country	:	US
Telephone Number	:	408-829-1975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2015
Last Update Date	:	09/19/2016

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Directions to “ CRYSTAL MORRIS ” Practice Location

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