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General NPI Number Information
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NPI Number | 1578642278
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Entity Type | Individual
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Provider Name | JANINE ANNETTE MOORE MARRIAGE AND FAMILY
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Gender | Female
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10000 COUNTY FARM ROAD
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City | RIVERSIDE
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State | CA
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Zip | 92503
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Country | US
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Telephone | 951-358-4390
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Fax | 951-358-4472
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Provider Business Mailing Address
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Address Line | PO BOX 70433
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City | RIVERSIDE
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State | CA
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Zip | 92513-0433
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Country | US
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Telephone | 951-358-4390
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Fax | 951-358-4472
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC31899
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License Number State | CA
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