MEDICARE: NATALIE MARIE MORENO MED

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
1	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1457826950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE MARIE MORENO MED

Provider Business Mailing Address
First Line	:	119 W TORRANCE BLVD # 100
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-3600
Country	:	US
Telephone Number	:	310-374-3300
Fax Number	:	310-374-3307

Provider Business Practice Location Address
First Line	:	7827 FLORENCE AVE
Second Line	:
City	:	DOWNEY
State	:	CA
Zip	:	90240-3727
Country	:	US
Telephone Number	:	310-374-3300
Fax Number	:	310-374-3307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2018
Last Update Date	:	05/14/2026

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Directions to “ NATALIE MARIE MORENO MED” Practice Location

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