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General NPI Number Information
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NPI Number | 1669860599
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Entity Type | Individual
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Provider Name | CLAUDIA MOOSE ATC, CSCS, PMA-CPT
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Gender | Female
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 3658 MT DIABLO BLVD STE 101
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City | LAFAYETTE
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State | CA
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Zip | 94549-6885
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Country | US
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Telephone | 925-299-9642
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Fax |
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Provider Business Mailing Address
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Address Line | 3658 MT DIABLO BLVD STE 101
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City | LAFAYETTE
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State | CA
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Zip | 94549-6885
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Country | US
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Telephone | 925-299-9642
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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