Basic Information
Provider Information
NPI: 1811034002
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRISON
FirstName: JAMES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 590 W PUTNAM AVE
Address2: SUITE 8
City: PORTERVILLE
State: CA
PostalCode: 932573257
CountryCode: US
TelephoneNumber: 5597816550
FaxNumber: 5597814350
Practice Location
Address1: 590 W PUTNAM AVE
Address2: SUITE 8
City: PORTERVILLE
State: CA
PostalCode: 932573257
CountryCode: US
TelephoneNumber: 5597816550
FaxNumber: 5597814350
Other Information
ProviderEnumerationDate: 01/30/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000XPSY19055CAY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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