Provider Demographics
NPI:1366284853
Name:MORALES, ANNA-MARIE (MT)
Entity type:Individual
Prefix:
First Name:ANNA-MARIE
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 BAYWOOD DR APT 202
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3340
Mailing Address - Country:US
Mailing Address - Phone:909-569-9111
Mailing Address - Fax:
Practice Address - Street 1:1121 BAYWOOD DR APT 202
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3340
Practice Address - Country:US
Practice Address - Phone:909-569-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88706225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist