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NPI Code Detail

MEDICARE: JAVIER G MORENO CATC

MEDICARE:   JAVIER G MORENO  CATC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorM0412311724CA

General Provider Information

NPI Number : 1982755385
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAVIER G MORENO CATC
Provider Business Mailing Address
First Line : 1018 21ST ST
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-4709
Country : US
Telephone Number : 661-861-9967
Fax Number :
Provider Business Practice Location Address
First Line : 1018 21ST ST
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93301-4709
Country : US
Telephone Number : 661-861-9967
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 01/21/2015

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Directions to “ JAVIER G MORENO CATC” Practice Location

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