MEDICARE: JESSICA RYAN MORRIS LPCC

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	101YM0800X	Mental Health Counselor	13275	CA

General Provider Information

NPI Number	:	1588393722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RYAN MORRIS LPCC

Provider Business Mailing Address
First Line	:	941 ORANGE AVE # 941
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-2609
Country	:	US
Telephone Number	:	619-459-0162
Fax Number	:

Provider Business Practice Location Address
First Line	:	941 ORANGE AVE # 1017
Second Line	:
City	:	CORONADO
State	:	CA
Zip	:	92118-2609
Country	:	US
Telephone Number	:	619-459-0162
Fax Number	:

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

Provider Enumeration Date	:	06/05/2022
Last Update Date	:	03/19/2025

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