MEDICARE: ALISON MOSER

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	103K00000X	Behavior Analyst	1-18-31390	CA

General Provider Information

NPI Number	:	1639679400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON MOSER

Provider Business Mailing Address
First Line	:	1225 PALOMAR PL APT 74
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92084-3560
Country	:	US
Telephone Number	:	760-975-9496
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 S WEITZEL ST APT 3
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-3253
Country	:	US
Telephone Number	:	760-975-9496
Fax Number	:

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

Provider Enumeration Date	:	02/17/2018
Last Update Date	:	08/15/2022

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