MEDICARE: MRS. PRINCESS MORGAN ASW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1356071799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PRINCESS MORGAN ASW

Provider Business Mailing Address
First Line	:	23727 CATHEDRAL PEAK RD
Second Line	:
City	:	MENIFEE
State	:	CA
Zip	:	92587-7250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23727 CATHEDRAL PEAK RD
Second Line	:
City	:	MENIFEE
State	:	CA
Zip	:	92587-7250
Country	:	US
Telephone Number	:	619-863-3111
Fax Number	:

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

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	06/16/2022

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