Healthcare Provider Details

I. General information

NPI: 1184272312
Provider Name (Legal Business Name): AMANDA MORGA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2019
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15405 LANSDOWNE RD STE C
TUSTIN CA
92782-0201
US

IV. Provider business mailing address

400 N TUSTIN AVE STE 120
SANTA ANA CA
92705-3879
US

V. Phone/Fax

Practice location:
  • Phone: 714-258-7710
  • Fax:
Mailing address:
  • Phone: 714-949-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number147165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: