Healthcare Provider Details

I. General information

NPI: 1821951260
Provider Name (Legal Business Name): MS. ANANDA MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 W COMMONWEALTH AVE STE C
FULLERTON CA
92832-1612
US

IV. Provider business mailing address

713 W COMMONWEALTH AVE
FULLERTON CA
92832-1612
US

V. Phone/Fax

Practice location:
  • Phone: 714-879-4274
  • Fax: 714-879-2274
Mailing address:
  • Phone: 714-879-4274
  • Fax: 714-879-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: