Healthcare Provider Details

I. General information

NPI: 1588505267
Provider Name (Legal Business Name): MITCHELL MOSCHETTI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 N CANYONS PKWY
LIVERMORE CA
94551-9185
US

IV. Provider business mailing address

348 N CANYONS PKWY
LIVERMORE CA
94551-9185
US

V. Phone/Fax

Practice location:
  • Phone: 925-365-7266
  • Fax:
Mailing address:
  • Phone: 925-365-7266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: