Provider Demographics
NPI:1104235753
Name:MORALES, JOSEPH ANTHONY
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:MORALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 GATEWAY BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-7401
Mailing Address - Country:US
Mailing Address - Phone:650-454-7570
Mailing Address - Fax:650-573-1023
Practice Address - Street 1:801 GATEWAY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-7401
Practice Address - Country:US
Practice Address - Phone:650-454-7570
Practice Address - Fax:650-573-1023
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)