Provider Demographics
NPI:1013330620
Name:ACEVEDO-MORAN, STEPHANIE ARIANA (LMFT, LAADC,BCBA)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ARIANA
Last Name:ACEVEDO-MORAN
Suffix:
Gender:F
Credentials:LMFT, LAADC,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10332 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4425
Mailing Address - Country:US
Mailing Address - Phone:714-743-0704
Mailing Address - Fax:
Practice Address - Street 1:5212 KATELLA AVE STE 103B
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6828
Practice Address - Country:US
Practice Address - Phone:714-743-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALR05740121101YA0400X
CA1-14-10236103K00000X
CA98990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst