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NPI Code Detail

MEDICARE: CYNTHIA MORENO

MEDICARE:   CYNTHIA  MORENO
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
1101YM0800XMental Health Counselor
2101Y00000XCounselor

General Provider Information

NPI Number : 1265586390
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA MORENO
Provider Business Mailing Address
First Line : 3050 BEACON BLVD STE 103
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95691-3467
Country : US
Telephone Number : 530-230-1285
Fax Number :
Provider Business Practice Location Address
First Line : 3050 BEACON BLVD STE 103
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95691-3467
Country : US
Telephone Number : 530-230-1285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 10/01/2018

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Directions to “ CYNTHIA MORENO ” Practice Location

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