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General NPI Number Information
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NPI Number | 1770753360
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Entity Type | Individual
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Provider Name | BOBBYE JEAN MOORE CATC
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Gender | Female
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 2290 DIAMOND BLVD STE 200
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City | CONCORD
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State | CA
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Zip | 94520-5742
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Country | US
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Telephone | 925-798-7250
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Fax | 925-798-3359
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Provider Business Mailing Address
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Address Line | 1073 SPARROW LN
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City | FAIRFIELD
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State | CA
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Zip | 94533-2429
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Country | US
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Telephone | 707-718-6027
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Fax | 707-759-4515
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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 | M1007281844
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License Number State | CA
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