Provider Demographics
NPI:1508261751
Name:MORGA, ADRIANA PEREDA (NP)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:PEREDA
Last Name:MORGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:
Other - Last Name:PEREDA MORGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2133 W BEVERLY BLVD
Mailing Address - Street 2:STE. 200
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3973
Mailing Address - Country:US
Mailing Address - Phone:323-201-5200
Mailing Address - Fax:
Practice Address - Street 1:2133 W BEVERLY BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3973
Practice Address - Country:US
Practice Address - Phone:323-201-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001394363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health