Healthcare Provider Details

I. General information

NPI: 1477963395
Provider Name (Legal Business Name): BROOKE MORALES PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2014
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SCOFIELD AVE
WASCO CA
93280-7515
US

IV. Provider business mailing address

PO BOX 20671
BAKERSFIELD CA
93390-0671
US

V. Phone/Fax

Practice location:
  • Phone: 661-758-8400
  • Fax:
Mailing address:
  • Phone: 661-758-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number31151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: