MEDICARE: LOUIS MOODY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	743045262	OTHER	CA	TAX ID

General Provider Information

NPI Number	:	1003938135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS MOODY

Provider Business Mailing Address
First Line	:	1913 S SHADYDALE AVE
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790-4621
Country	:	US
Telephone Number	:	626-536-9311
Fax Number	:

Provider Business Practice Location Address
First Line	:	11227 VALLEY BLVD STE 100
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-3299
Country	:	US
Telephone Number	:	626-444-0507
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	09/20/2021

Similar Medicare Providers

1619722691 — NANCY OROPEZA
Practice Location Address:

11227 VALLEY BLVD STE 100
EL MONTE, CA
91731-3299

Practice Phone: 626-444-0705
Practice Fax: 626-444-0710

1528213444 — MARIAH MADRIGAL
Practice Location Address:

11227 VALLEY BLVD STE 100
EL MONTE, CA
91731-3299

Practice Phone: 626-444-0705
Practice Fax: 626-444-0710

1891938510 — DORIS LA VERNE THOMAS CADPT 10145
Practice Location Address:

11227 VALLEY BLVD
EL MONTE, CA
91731-3299

Practice Phone: 626-444-0704
Practice Fax: 626-246-3046

1003464090 — PRISCILLA ELENA HERNANDEZ SALAZAR B00004361225
Practice Location Address:

11227 VALLEY BLVD STE 100
EL MONTE, CA
91731-3299

Practice Phone: 626-444-0705
Practice Fax:

1356973465 — APRIL L NEWMAN
Practice Location Address:

11227 VALLEY BLVD STE 100
EL MONTE, CA
91731-3299

Practice Phone: 626-444-0705
Practice Fax: 626-444-0705

1699367482 — BARBARA WALLACE
Practice Location Address:

11227 VALLEY BLVD
EL MONTE, CA
91731-3299

Practice Phone: 626-444-0705
Practice Fax: 626-444-0710

Directions to “ LOUIS MOODY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.