Healthcare Provider Details

I. General information

NPI: 1225764442
Provider Name (Legal Business Name): JOSHUA J MOSS-PARNELL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 ROSEMEAD BLVD APT 34
SAN GABRIEL CA
91775-1555
US

IV. Provider business mailing address

6825 ROSEMEAD BLVD APT 34
SAN GABRIEL CA
91775-1555
US

V. Phone/Fax

Practice location:
  • Phone: 417-631-5433
  • Fax:
Mailing address:
  • Phone: 417-631-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: