Provider Demographics
NPI:1598045213
Name:MORALES, STEVEN ROQUE (LCSW)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROQUE
Last Name:MORALES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 E SANTA CLARA ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-2244
Mailing Address - Country:US
Mailing Address - Phone:408-792-3928
Mailing Address - Fax:408-792-2159
Practice Address - Street 1:1075 E SANTA CLARA ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2244
Practice Address - Country:US
Practice Address - Phone:408-792-3928
Practice Address - Fax:408-792-2159
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS189561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical