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NPI Code Detail

MEDICARE: CYNTHIA ELAINE MORELAND C.A.S.

MEDICARE: CYNTHIA ELAINE MORELAND C.A.S.
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
1171M00000XCase Manager/Care Coordinator01-047405CA
2101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101-047405OTHERCACOUNSELOR- ADDICTION (SUBSTANCE USE DISORDER)
2997811OTHERCACARE COORDINATOR

General Provider Information

NPI Number : 1104044205
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA ELAINE MORELAND C.A.S.
Provider Business Mailing Address
First Line : 2307 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3119
Country : US
Telephone Number : 213-351-2800
Fax Number :
Provider Business Practice Location Address
First Line : 2307 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3119
Country : US
Telephone Number : 213-351-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 04/14/2020

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