Provider Demographics
NPI:1407982655
Name:MALEK-MORENO, DINA (LCSW)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:MALEK-MORENO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:MALEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:384 E OLIVE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4051
Mailing Address - Country:US
Mailing Address - Phone:209-252-6658
Mailing Address - Fax:209-633-5742
Practice Address - Street 1:384 E OLIVE AVE STE 1
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380
Practice Address - Country:US
Practice Address - Phone:209-252-6658
Practice Address - Fax:209-633-5742
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA218831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical