Provider Demographics
NPI:1598403594
Name:MORALES, MARIA REGINA (AMFT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:REGINA
Last Name:MORALES
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E HICKORY AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7274
Mailing Address - Country:US
Mailing Address - Phone:805-588-4582
Mailing Address - Fax:805-430-8151
Practice Address - Street 1:115 E HICKORY AVE STE C
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7274
Practice Address - Country:US
Practice Address - Phone:805-588-4582
Practice Address - Fax:805-430-8151
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist