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General NPI Number Information
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NPI Number | 1023177458
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Entity Type | Individual
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Provider Name | GRACE ELIZABETH MOOREFIELD MSN, ARN, BC
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Gender | Female
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 701 EAST FOOTHILL BOULEVARD
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City | AZUSA
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State | CA
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Zip | 91702-7000
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Country | US
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Telephone | 626-253-2818
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Fax | 626-606-0234
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Provider Business Mailing Address
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Address Line | P.O. BOX 1494
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City | GLENDORA
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State | CA
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Zip | 91740-1494
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Country | US
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Telephone | 626-253-2818
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Fax | 626-606-0234
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | RN257013
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License Number State | CA
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