Healthcare Provider Details

I. General information

NPI: 1649149071
Provider Name (Legal Business Name): JAVIER MORALES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 NORTH DR
DALLAS TX
75207-4431
US

IV. Provider business mailing address

447 SUTTER ST STE 405
SAN FRANCISCO CA
94108-4618
US

V. Phone/Fax

Practice location:
  • Phone: 415-992-6155
  • Fax:
Mailing address:
  • Phone: 415-992-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96495
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: