Healthcare Provider Details

I. General information

NPI: 1811045388
Provider Name (Legal Business Name): JOEL ANGEL MORENO CADC-CAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 ROSEDALE HIGHWAY
BAKERSFIELD CA
93308
US

IV. Provider business mailing address

7115 ROSEDALE HWY
BAKERSFIELD CA
93308-5845
US

V. Phone/Fax

Practice location:
  • Phone: 661-589-4242
  • Fax:
Mailing address:
  • Phone: 661-827-3458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC051810318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: