Healthcare Provider Details

I. General information

NPI: 1750650867
Provider Name (Legal Business Name): PRECIOUS JEWEL MOSES MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53241 COMPASSION WAY
LAKE ELSINORE CA
92532-1627
US

IV. Provider business mailing address

53241 COMPASSION WAY
LAKE ELSINORE CA
92532-1627
US

V. Phone/Fax

Practice location:
  • Phone: 323-474-1436
  • Fax:
Mailing address:
  • Phone: 323-474-1436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: