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NPI Code Detail

MEDICARE: MS. NIDIA M MORAN CANALES

MEDICARE: MS. NIDIA M MORAN CANALES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLMFT51634CA

General Provider Information

NPI Number : 1063719235
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NIDIA M MORAN CANALES
Provider Business Mailing Address
First Line : 555 E OCEAN BLVD STE 330
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-5052
Country : US
Telephone Number : 562-542-1144
Fax Number : 951-346-5511
Provider Business Practice Location Address
First Line : 555 E OCEAN BLVD STE 330
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-5052
Country : US
Telephone Number : 562-542-1144
Fax Number : 951-346-5511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 10/30/2025

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