Provider Demographics
NPI:1841741279
Name:MORREALE, LORINDA
Entity Type:Individual
Prefix:
First Name:LORINDA
Middle Name:
Last Name:MORREALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13940 HOPI RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-5715
Mailing Address - Country:US
Mailing Address - Phone:714-746-5382
Mailing Address - Fax:
Practice Address - Street 1:15428 CIVIC DR. STE 200
Practice Address - Street 2:ACT FAMILY COUNSELING
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392
Practice Address - Country:US
Practice Address - Phone:442-255-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 30195106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist