Healthcare Provider Details

I. General information

NPI: 1104783133
Provider Name (Legal Business Name): MR. JUAN FRANCISCO MORENO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14325 GOLDENWEST ST
WESTMINSTER CA
92683-4999
US

IV. Provider business mailing address

14325 GOLDENWEST ST
WESTMINSTER CA
92683-4999
US

V. Phone/Fax

Practice location:
  • Phone: 714-893-1381
  • Fax:
Mailing address:
  • Phone: 714-893-1381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230152302
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: