Provider Demographics
NPI:1558058230
Name:MORALES, JAMEE MARGARET (ATC)
Entity Type:Individual
Prefix:
First Name:JAMEE
Middle Name:MARGARET
Last Name:MORALES
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:JAMEE
Other - Middle Name:MARGARET
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1100 CALLE DEL CERRO APT 22B
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-6023
Mailing Address - Country:US
Mailing Address - Phone:949-636-6508
Mailing Address - Fax:
Practice Address - Street 1:28000 MARGUERITE PKWY
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3635
Practice Address - Country:US
Practice Address - Phone:949-582-4216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110002223207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine