Provider Demographics
NPI:1932450186
Name:MORALES, OLIVIA ANNE
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANNE
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 1:8243 NORWALK BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-3164
Mailing Address - Country:US
Mailing Address - Phone:562-321-7440
Mailing Address - Fax:
Practice Address - Street 1:17195 NEWHOPE ST STE 210
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4211
Practice Address - Country:US
Practice Address - Phone:657-360-4329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF79714106H00000X
CA138673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist