Healthcare Provider Details

I. General information

NPI: 1912836370
Provider Name (Legal Business Name): ESTHER MOON OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5297 MAUREEN LN
MOORPARK CA
93021-7125
US

IV. Provider business mailing address

5297 MAUREEN LN
MOORPARK CA
93021-7125
US

V. Phone/Fax

Practice location:
  • Phone: 805-378-6300
  • Fax:
Mailing address:
  • Phone: 805-378-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT1238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: