MEDICARE: LORIE ANN MOORE

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1639316375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORIE ANN MOORE

Provider Business Mailing Address
First Line	:	12523 LIMONITE AVE STE 440-310
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	91752-3665
Country	:	US
Telephone Number	:	951-367-8378
Fax Number	:	951-281-0307

Provider Business Practice Location Address
First Line	:	12523 LIMONITE AVE UNIT 440-310
Second Line	:
City	:	EASTVALE
State	:	CA
Zip	:	91752-3665
Country	:	US
Telephone Number	:	951-367-8378
Fax Number	:	951-281-0307

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

Provider Enumeration Date	:	01/16/2009
Last Update Date	:	12/04/2025

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Directions to “ LORIE ANN MOORE ” Practice Location

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