MEDICARE: DR. PATRICIA MORALES PSYD, LP

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	103T00000X	Psychologist	22639	CA
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1467650689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA MORALES PSYD, LP

Provider Business Mailing Address
First Line	:	1577 E CHEVY CHASE DR STE 120
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4193
Country	:	US
Telephone Number	:	818-240-0340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1577 E CHEVY CHASE DR STE 120
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-4193
Country	:	US
Telephone Number	:	818-240-0340
Fax Number	:

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

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	04/13/2026

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