Healthcare Provider Details

I. General information

NPI: 1558678961
Provider Name (Legal Business Name): JOHN NICHOLAS MORIANA LCSW133406
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NICK MORIANA LCSW133406

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 HILLCREST AVE
ANTIOCH CA
94531-4263
US

IV. Provider business mailing address

3454 HILLCREST AVE
ANTIOCH CA
94531-4263
US

V. Phone/Fax

Practice location:
  • Phone: 925-777-6300
  • Fax:
Mailing address:
  • Phone: 925-777-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW133406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: