Healthcare Provider Details

I. General information

NPI: 1649850454
Provider Name (Legal Business Name): BARBARA DIANE MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 REYNOLDS RD
RIVERSIDE CA
92503-3517
US

IV. Provider business mailing address

13684 JEREMY CT
RANCHO CUCAMONGA CA
91739-2031
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number240669
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: