Basic Information
| Provider Information | |||||||||
| NPI: | 1750502647 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORALES | ||||||||
| FirstName: | MELBA | ||||||||
| MiddleName: | MARINA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW#66639 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 921 E COMPTON BLVD | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902213303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106686800 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11605 ESTHER ST | ||||||||
| Address2: | APARTMENT E | ||||||||
| City: | LYNWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902624141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5623418219 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.