Provider Demographics
NPI:1942243399
Name:MORALES, SHARLA BETH (AUD)
Entity Type:Individual
Prefix:
First Name:SHARLA
Middle Name:BETH
Last Name:MORALES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 WILLOW LN STE 218
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4992
Mailing Address - Country:US
Mailing Address - Phone:805-870-4498
Mailing Address - Fax:805-870-4625
Practice Address - Street 1:3180 WILLOW LN STE 218
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-4992
Practice Address - Country:US
Practice Address - Phone:805-870-4498
Practice Address - Fax:805-870-4625
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2117174400000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0002117Medicaid