Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | G55797 | CA |
NPI | 1003913781 |
---|---|
Provider Name | Dr. Ellen C Morrissey |
First Address | Berkeley, CA 94705-2063 |
Second Address | Berkeley, CA 94705-2063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G557970 | (05) | CA |
E37911 | (02) | CA |