Provider Demographics
NPI:1902935596
Name:MORRIS, RICKY (LMFT)
Entity Type:Individual
Prefix:MR
First Name:RICKY
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 BLUE ANCHOR LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-7250
Mailing Address - Country:US
Mailing Address - Phone:408-667-0676
Mailing Address - Fax:
Practice Address - Street 1:2001 SALVIO ST STE 28
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2495
Practice Address - Country:US
Practice Address - Phone:209-290-8564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105568106H00000X
CA69963106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA105568OtherBOARD OF BEHAVIORAL SCIENCES