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NPI Code Detail

MEDICARE: STEPHANIE MOYADO

MEDICARE: STEPHANIE MOYADO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1326999764
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MOYADO
Provider Business Mailing Address
First Line : 555 MCCONNELL AVE APT 8
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-2859
Country : US
Telephone Number : 707-765-8488
Fax Number :
Provider Business Practice Location Address
First Line : 1500 PETALUMA BLVD S STE A
Second Line :
City : PETALUMA
State : CA
Zip : 94952-5546
Country : US
Telephone Number : 707-765-8488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ STEPHANIE MOYADO ” Practice Location

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