Provider Demographics
NPI:1801255070
Name:MORALES CHAVARRIA, MARIA GABRIELA
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:GABRIELA
Last Name:MORALES CHAVARRIA
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 1:10417 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-6810
Mailing Address - Country:US
Mailing Address - Phone:661-845-5100
Mailing Address - Fax:661-845-5106
Practice Address - Street 1:3105 WILSON ROAD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-6810
Practice Address - Country:US
Practice Address - Phone:661-397-8775
Practice Address - Fax:661-397-8786
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA117734106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator