Provider Demographics
NPI:1720715055
Name:MORALES, SCHAYENNE TEODORO
Entity Type:Individual
Prefix:MISS
First Name:SCHAYENNE
Middle Name:TEODORO
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 1:40015 SIERRA HWY STE B280
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2143
Mailing Address - Country:US
Mailing Address - Phone:661-992-8740
Mailing Address - Fax:
Practice Address - Street 1:40015 SIERRA HWY STE B280
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2143
Practice Address - Country:US
Practice Address - Phone:661-992-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT110230106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist