Healthcare Provider Details

I. General information

NPI: 1396535811
Provider Name (Legal Business Name): BRITTANY MARIE MOORE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 LINCOLN ST
OROVILLE CA
95966-5961
US

IV. Provider business mailing address

3485 BURLINGTON AVE
OROVILLE CA
95966-6584
US

V. Phone/Fax

Practice location:
  • Phone: 530-534-7500
  • Fax:
Mailing address:
  • Phone: 530-716-0321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRI542490124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: