Provider Demographics
NPI:1588488100
Name:MORALES, LAURA PATRICIA (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:PATRICIA
Last Name:MORALES
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 PACIFIC COAST HWY STE S
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2660
Mailing Address - Country:US
Mailing Address - Phone:424-347-8008
Mailing Address - Fax:
Practice Address - Street 1:2040 PACIFIC COAST HWY STE S
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-2660
Practice Address - Country:US
Practice Address - Phone:424-347-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily