Provider Demographics
NPI:1700682549
Name:MORAN, KIRA SOFIA
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:SOFIA
Last Name:MORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5790 BUCKNELL AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-1302
Mailing Address - Country:US
Mailing Address - Phone:747-363-0020
Mailing Address - Fax:
Practice Address - Street 1:3210 W BURBANK BLVD STE B
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2200
Practice Address - Country:US
Practice Address - Phone:818-638-9586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician