Healthcare Provider Details

I. General information

NPI: 1750194106
Provider Name (Legal Business Name): GUILLERMINA MORALES MSW, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HERMOSA AVE
COLTON CA
92324-1901
US

IV. Provider business mailing address

PO BOX 1303
ADELANTO CA
92301-1109
US

V. Phone/Fax

Practice location:
  • Phone: 909-580-5000
  • Fax:
Mailing address:
  • Phone: 760-508-7524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW116552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: