Healthcare Provider Details

I. General information

NPI: 1346105442
Provider Name (Legal Business Name): CRISTAL MORALES
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4695 MACARTHUR CT STE 1100
NEWPORT BEACH CA
92660-1866
US

IV. Provider business mailing address

350 FAIRWAY DRIVE SUITE 101
DEERFIELD BEACH FL
33441
US

V. Phone/Fax

Practice location:
  • Phone: 949-720-2550
  • Fax:
Mailing address:
  • Phone: 877-418-2978
  • Fax: 866-500-2186

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: