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General NPI Number Information
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NPI Number | 1417533563
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Entity Type | Individual
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Provider Name | JULIE NICOLE MOONEY
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Gender | Female
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 1820 S CENTRAL ST STE C
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City | VISALIA
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State | CA
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Zip | 93277-4420
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Country | US
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Telephone | 559-372-7002
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Fax |
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Provider Business Mailing Address
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Address Line | 7250 LICKEY CT
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City | VISALIA
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State | CA
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Zip | 93291-9264
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Country | US
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Telephone | 559-799-5412
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CACS5130122
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License Number State | CA
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