Healthcare Provider Details

I. General information

NPI: 1518800697
Provider Name (Legal Business Name): ARACELY MORALES MORENO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37479 AVENUE 12
MADERA CA
93636-8726
US

IV. Provider business mailing address

2474 TWAIN AVE
CLOVIS CA
93611-5973
US

V. Phone/Fax

Practice location:
  • Phone: 559-645-3570
  • Fax:
Mailing address:
  • Phone: 559-645-3570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number250157392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: