Healthcare Provider Details

I. General information

NPI: 1023978848
Provider Name (Legal Business Name): DR. ANDREW JOSEPH MORALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

696 HAMPSHIRE RD STE 210
THOUSAND OAKS CA
91361-4460
US

IV. Provider business mailing address

110 JENSEN CT STE 2C
THOUSAND OAKS CA
91360-7485
US

V. Phone/Fax

Practice location:
  • Phone: 805-777-7370
  • Fax: 805-777-7380
Mailing address:
  • Phone: 805-413-1070
  • Fax: 805-413-1076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: