Healthcare Provider Details

I. General information

NPI: 1992031843
Provider Name (Legal Business Name): ALMA MORENO ARANDA LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 W CIVIC CENTER DR STE 200
SANTA ANA CA
92701-4052
US

IV. Provider business mailing address

615 W CIVIC CENTER DR STE 200
SANTA ANA CA
92701-4052
US

V. Phone/Fax

Practice location:
  • Phone: 310-507-5280
  • Fax:
Mailing address:
  • Phone: 310-507-5280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code167G00000X
TaxonomyLicensed Psychiatric Technician
License Number31520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: