Provider Demographics
NPI:1043422793
Name:MORALES, DEBRA P (PHD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:P
Last Name:MORALES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24050 MADISON ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6015
Mailing Address - Country:US
Mailing Address - Phone:310-375-5103
Mailing Address - Fax:480-393-5038
Practice Address - Street 1:24050 MADISON ST
Practice Address - Street 2:SUITE 211
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6015
Practice Address - Country:US
Practice Address - Phone:310-375-5103
Practice Address - Fax:480-393-5038
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15686103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist