Healthcare Provider Details

I. General information

NPI: 1184326944
Provider Name (Legal Business Name): MORANTE PSYCHIATRIC NURSING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 AVALON BLVD STE B
LOS ANGELES CA
90061-2866
US

IV. Provider business mailing address

28802 GARNET CANYON DR
SANTA CLARITA CA
91390-5263
US

V. Phone/Fax

Practice location:
  • Phone: 888-783-1883
  • Fax: 888-653-3144
Mailing address:
  • Phone: 661-888-0195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. PEDRO ESTRADA MORANTE
Title or Position: CEO
Credential: NP, PMHNP-BC, FNP-BC
Phone: 661-888-0195