MEDICARE: PATRICIA IVETH MORAN

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	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1871441345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA IVETH MORAN

Provider Business Mailing Address
First Line	:	4661 PLUMOSA DR APT 33
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-2471
Country	:	US
Telephone Number	:	661-481-5302
Fax Number	:

Provider Business Practice Location Address
First Line	:	4661 PLUMOSA DR APT 33
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-2471
Country	:	US
Telephone Number	:	661-481-5302
Fax Number	:

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

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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Directions to “ PATRICIA IVETH MORAN ” Practice Location

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