Provider Demographics
NPI:1053748483
Name:MORIN, LUCIEN C (MSN, PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:LUCIEN
Middle Name:C
Last Name:MORIN
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93442
Mailing Address - Country:US
Mailing Address - Phone:805-771-1858
Mailing Address - Fax:
Practice Address - Street 1:2626 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442
Practice Address - Country:US
Practice Address - Phone:805-440-7708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA379858363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health