Provider Demographics
NPI:1457857369
Name:MORALES, MARISOL AHUMADA
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:AHUMADA
Last Name:MORALES
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 1:176 GREENBRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-2100
Mailing Address - Country:US
Mailing Address - Phone:831-757-4768
Mailing Address - Fax:
Practice Address - Street 1:4 ROSSI CIR STE 231
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2358
Practice Address - Country:US
Practice Address - Phone:831-424-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2018-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician