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NPI Code Detail

MEDICARE: ANGELICA MORENO

MEDICARE: ANGELICA MORENO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1871885467
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELICA MORENO
Provider Business Mailing Address
First Line : 25800 INDUSTRIAL BLVD APT L300
Second Line :
City : HAYWARD
State : CA
Zip : 94545-2948
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5815 3RD ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94124-3101
Country : US
Telephone Number : 415-822-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2011
Last Update Date : 02/15/2019

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Directions to “ ANGELICA MORENO ” Practice Location

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