Provider Demographics
NPI:1821735028
Name:MORATAYA, OSCAR ADOLFO JR
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:ADOLFO
Last Name:MORATAYA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 BONNIE CASTLE WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-7725
Mailing Address - Country:US
Mailing Address - Phone:702-945-6355
Mailing Address - Fax:
Practice Address - Street 1:1529 BONNIE CASTLE WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-7725
Practice Address - Country:US
Practice Address - Phone:702-945-6355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician