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General NPI Number Information
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NPI Number | 1962050807
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Entity Type | Individual
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Provider Name | MARIA ANGELICA FRAIRE-MORALES MSW
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Gender | Female
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 18321 CLARK ST
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City | TARZANA
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State | CA
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Zip | 91356-3501
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Country | US
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Telephone | 818-708-5460
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45
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City | CANOGA PARK
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State | CA
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Zip | 91305-0045
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Country | US
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Telephone | 818-835-6102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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