Healthcare Provider Details

I. General information

NPI: 1922964253
Provider Name (Legal Business Name): TALIA MOORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 SPRUCE ST UNIT 401
MOUNTAIN VIEW CA
94043-0017
US

IV. Provider business mailing address

1170 SPRUCE ST UNIT 401
MOUNTAIN VIEW CA
94043-0017
US

V. Phone/Fax

Practice location:
  • Phone: 323-709-8027
  • Fax:
Mailing address:
  • Phone: 323-709-8027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number10749
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: