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NPI Code Detail

MEDICARE: DR. MARCUS A MOSES PSYD

MEDICARE: DR. MARCUS A MOSES PSYD
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
1103T00000XPsychologistCA

General Provider Information

NPI Number : 1619774882
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCUS A MOSES PSYD
Provider Business Mailing Address
First Line : 2140 N WINERY AVE STE 101
Second Line :
City : FRESNO
State : CA
Zip : 93703-4807
Country : US
Telephone Number : 559-216-0125
Fax Number : 559-201-6363
Provider Business Practice Location Address
First Line : 2140 N WINERY AVE STE 101
Second Line :
City : FRESNO
State : CA
Zip : 93703-4807
Country : US
Telephone Number : 559-216-0125
Fax Number : 559-201-6363
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2025
Last Update Date : 02/26/2025

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