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NPI Code Detail

MEDICARE: CHRISTINA MOON

MEDICARE: CHRISTINA MOON
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
1101Y00000XCounselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1356971600
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA MOON
Provider Business Mailing Address
First Line : 809 FULTON AVE APT 2112
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-6446
Country : US
Telephone Number : 951-284-9952
Fax Number :
Provider Business Practice Location Address
First Line : 6876 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-2860
Country : US
Telephone Number : 626-808-6032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2020
Last Update Date : 08/27/2024

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Directions to “ CHRISTINA MOON ” Practice Location

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