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General NPI Number Information
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NPI Number | 1891162384
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Entity Type | Individual
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Provider Name | CASANDRA MOYER APRN
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Gender | Female
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 2309 NORIEGA ST STE 888
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-4239
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Country | US
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Telephone | 843-474-5578
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Fax | 843-790-1871
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 843-474-5578
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Fax | 843-790-1871
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95002698
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 95002698
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202109748
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95002698
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License Number State | CA
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