MEDICARE: MONIQUE ASHLEY MOSES

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	171M00000X	Case Manager/Care Coordinator
2	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1689762486	OTHER	CA	MCMILLAN RANCH

General Provider Information

NPI Number	:	1508017690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE ASHLEY MOSES

Provider Business Mailing Address
First Line	:	5762 BOLSA AVE STE 101
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-1172
Country	:	US
Telephone Number	:	714-292-2322
Fax Number	:	714-866-4153

Provider Business Practice Location Address
First Line	:	5762 BOLSA AVE STE 101
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-1172
Country	:	US
Telephone Number	:	714-292-2322
Fax Number	:	714-866-4153

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

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	02/08/2026

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Directions to “ MONIQUE ASHLEY MOSES ” Practice Location

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