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NPI Code Detail

MEDICARE: JULIE RAE MORALEZ

MEDICARE:   JULIE RAE MORALEZ
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1881291854
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE RAE MORALEZ
Provider Business Mailing Address
First Line : 130 W FLORA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95202-1636
Country : US
Telephone Number : 925-758-3892
Fax Number :
Provider Business Practice Location Address
First Line : 130 W FLORA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95202-1636
Country : US
Telephone Number : 925-758-3892
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2020
Last Update Date : 10/02/2020

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Directions to “ JULIE RAE MORALEZ ” Practice Location

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