Provider Demographics
NPI:1184975930
Name:MORALES, EMILY NIDYA
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:NIDYA
Last Name:MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:NIDYA
Other - Last Name:BARBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 91698
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-1698
Mailing Address - Country:US
Mailing Address - Phone:626-765-1905
Mailing Address - Fax:
Practice Address - Street 1:7300 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2233
Practice Address - Country:US
Practice Address - Phone:310-855-3276
Practice Address - Fax:310-393-9893
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120069106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist