Provider Demographics
NPI:1225322209
Name:MORALES-AVENDANO, GUADALUPE
Entity Type:Individual
Prefix:MRS
First Name:GUADALUPE
Middle Name:
Last Name:MORALES-AVENDANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20963 E COVINA BLVD
Mailing Address - Street 2:APRT. K
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1844
Mailing Address - Country:US
Mailing Address - Phone:626-915-3844
Mailing Address - Fax:626-915-3845
Practice Address - Street 1:1721 GRIFFIN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-3312
Practice Address - Country:US
Practice Address - Phone:909-773-8556
Practice Address - Fax:626-915-3845
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health