Provider Demographics
NPI:1770724106
Name:MORLET, ELIZABETH SHARON
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SHARON
Last Name:MORLET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:SHARON
Other - Last Name:ASCENCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8821 LUCIA AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2045
Mailing Address - Country:US
Mailing Address - Phone:562-381-4764
Mailing Address - Fax:
Practice Address - Street 1:9829 CARMENITA RD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-3229
Practice Address - Country:US
Practice Address - Phone:562-381-4764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-15
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health