Healthcare Provider Details

I. General information

NPI: 1639034119
Provider Name (Legal Business Name): NEVAEH C MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 ACACIA RD APT D
SANTA PAULA CA
93060-3196
US

IV. Provider business mailing address

450 ACACIA RD APT D
SANTA PAULA CA
93060-3196
US

V. Phone/Fax

Practice location:
  • Phone: 805-940-8243
  • Fax:
Mailing address:
  • Phone: 805-940-8243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberY6755397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: