Provider Demographics
NPI:1134264104
Name:MORENO ORTIZ, AMALIA (LMFT)
Entity type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:MORENO ORTIZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMALIA
Other - Middle Name:
Other - Last Name:MORENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 S PARKER ST STE 2800
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4720
Mailing Address - Country:US
Mailing Address - Phone:925-282-1778
Mailing Address - Fax:
Practice Address - Street 1:701 S PARKER ST STE 2800
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4720
Practice Address - Country:US
Practice Address - Phone:925-282-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153273106H00000X
CA128719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist