Healthcare Provider Details

I. General information

NPI: 1154513679
Provider Name (Legal Business Name): CINDIE MARIE MOYER M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 56TH ST
OAKLAND CA
94608-3228
US

IV. Provider business mailing address

840 56TH ST
OAKLAND CA
94608-3228
US

V. Phone/Fax

Practice location:
  • Phone: 510-386-5524
  • Fax:
Mailing address:
  • Phone: 510-386-5524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFC35560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: