Provider Demographics
NPI:1336440494
Name:MORENO, YARA ROSAS
Entity Type:Individual
Prefix:MRS
First Name:YARA
Middle Name:ROSAS
Last Name:MORENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YARA
Other - Middle Name:
Other - Last Name:ROSAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1845 W ORANGEWOOD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2051
Mailing Address - Country:US
Mailing Address - Phone:949-929-3261
Mailing Address - Fax:
Practice Address - Street 1:1845 W ORANGEWOOD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2051
Practice Address - Country:US
Practice Address - Phone:949-929-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist