Provider Demographics
NPI:1679798268
Name:MORALES, GLORIA YOLANDA (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:YOLANDA
Last Name:MORALES
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:Y
Other - Last Name:MORALES RAYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:24564 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-375-3526
Mailing Address - Fax:
Practice Address - Street 1:24564 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-375-3526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS148881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW14888Medicaid
CASW14888Medicaid