Individual provider Active NPI

Teresita De Jesus Morales, PHD

  • Clinical Psychologist
  • South Pasadena, CA
National Provider Identifier
1912005034
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16668 Issued in CA
Practice address
625 Fair Oaks Avenue
Suite 390
South Pasadena, CA 91030
Phone
(626) 449-2484
Fax
(626) 449-1107
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY16668 CA Primary

Addresses

Primary practice location

625 Fair Oaks Avenue
Suite 390
South Pasadena, CA 91030

Mailing address

4615 W 130TH St
Hawthorne, CA 90250-5146
Phone (626) 449-2484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040715001446 CA Practitioner - Clinical Psychologist 2466431143

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 N Lake
Suite 800
Pasadena, CA 91101

2 N Lake Ave
Suite 800
Pasadena, CA 91101-1870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
16668CAMDProfessional Counselor
PSY16668CAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1912005034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 W 130TH ST",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505146",
            "telephone_number": "626-449-2484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 FAIR OAKS AVENUE",
            "address_2": "SUITE 390",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "91030",
            "telephone_number": "626-449-2484",
            "fax_number": "626-449-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "TERESITA",
        "middle_name": "DE JESUS",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.