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General NPI Number Information
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NPI Number | 1104795731
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Entity Type | Organization
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Legal Business Name | MICHELLE MOORE PHD INC. A PROFESSIONAL PSYCHOLOGICAL CORPORA
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 2413 APPIAN RD
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City | CARLSBAD
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State | CA
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Zip | 92010-2153
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Country | US
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Telephone | 949-933-1570
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Fax |
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Provider Business Mailing Address
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Address Line | 2413 APPIAN RD
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City | CARLSBAD
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State | CA
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Zip | 92010-2153
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Country | US
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Telephone | 949-933-1570
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHELLE JOCELINE MOORE
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Credential | PHD
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Telephone | 949-933-1570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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