Provider Demographics
NPI:1871067900
Name:FUNG, MORGAN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:FUNG
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 802651
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-2651
Mailing Address - Country:US
Mailing Address - Phone:661-313-9535
Mailing Address - Fax:
Practice Address - Street 1:28494 WESTINGHOUSE PL STE 314
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0936
Practice Address - Country:US
Practice Address - Phone:661-210-3551
Practice Address - Fax:877-897-9391
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110597103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty