Healthcare Provider Details

I. General information

NPI: 1265349013
Provider Name (Legal Business Name): ALONDRA NICOLE MORENO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W MACARTHUR BLVD STE 207
SANTA ANA CA
92704-6972
US

IV. Provider business mailing address

437 S FLOWER AVE
BREA CA
92821-5439
US

V. Phone/Fax

Practice location:
  • Phone: 562-270-2970
  • Fax:
Mailing address:
  • Phone: 657-274-6307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: