MEDICARE: DR. JENNIFER SHERADEN MORSE M.D.

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	2084P0800X	Psychiatry Physician	C51037	CA

General Provider Information

NPI Number	:	1710925979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER SHERADEN MORSE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3439
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91944-3439
Country	:	US
Telephone Number	:	619-464-1165
Fax Number	:	619-464-1157

Provider Business Practice Location Address
First Line	:	1370 ROSECRANS ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92106-2638
Country	:	US
Telephone Number	:	619-819-7777
Fax Number	:	619-374-1947

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	07/08/2007

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