Healthcare Provider Details

I. General information

NPI: 1396346961
Provider Name (Legal Business Name): PATRICIA YAMILET MORALES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 ROSCOE BLVD DIGNITY HEALTH- NORTHRIDGE HOSPITAL M
NORTHRIDGE CA
91325
US

IV. Provider business mailing address

27100 LANGSIDE AVE.
CANYON COUNTRY CA
91351
US

V. Phone/Fax

Practice location:
  • Phone: 818-885-8500
  • Fax:
Mailing address:
  • Phone: 323-821-5782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number774111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: