MEDICARE: MICHELLE MORALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1275133928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MORALES

Provider Business Mailing Address
First Line	:	PO BOX 33568
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92163-3568
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 MARTIN RD STE 100
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-1018
Country	:	US
Telephone Number	:	855-223-7123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2020
Last Update Date	:	12/02/2025

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Directions to “ MICHELLE MORALES ” Practice Location

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