Healthcare Provider Details

I. General information

NPI: 1891163994
Provider Name (Legal Business Name): ASHLEY MOORE-MOTTE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 09/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ESSEX ST
SAN FRANCISCO CA
94105-3195
US

IV. Provider business mailing address

25 ESSEX ST
SAN FRANCISCO CA
94105-3195
US

V. Phone/Fax

Practice location:
  • Phone: 415-767-3404
  • Fax:
Mailing address:
  • Phone: 415-767-3404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number810817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: