Provider Demographics
NPI:1033380761
Name:MORALES, SHENYELL ARLU (FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:SHENYELL
Middle Name:ARLU
Last Name:MORALES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:SHENYELL
Other - Middle Name:ARLU
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC, FNP-C
Mailing Address - Street 1:4211 AVALON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90011-5622
Mailing Address - Country:US
Mailing Address - Phone:323-515-7006
Mailing Address - Fax:323-515-7006
Practice Address - Street 1:4211 AVALON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90011-5622
Practice Address - Country:US
Practice Address - Phone:323-515-7006
Practice Address - Fax:323-515-7006
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16802363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF0208258OtherAANP CERTIFICATION
CA2011013408OtherAMERICAN NURSES CREDENTIALING CENTER
CADP906ZMedicare PIN