Healthcare Provider Details

I. General information

NPI: 1528788676
Provider Name (Legal Business Name): SABRINA MOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16500 VENTURA BLVD STE 414
ENCINO CA
91436-5050
US

IV. Provider business mailing address

16500 VENTURA BLVD STE 414
ENCINO CA
91436-5050
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-1003
  • Fax:
Mailing address:
  • Phone: 818-788-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: