Provider Demographics
NPI:1083132153
Name:MORALES, RUTH TAMAR (OT)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:TAMAR
Last Name:MORALES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 N BROADWAY APT 199
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-1807
Mailing Address - Country:US
Mailing Address - Phone:760-840-0739
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S OT SERVICES, INC
Practice Address - Street 2:9606 TIERRA GRANDE ST., #104
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126
Practice Address - Country:US
Practice Address - Phone:858-695-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA166225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist