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NPI Code Detail

MEDICARE: MELANIE TERRAS MOORE LCSW

MEDICARE: MELANIE TERRAS MOORE LCSW
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
11041C0700XClinical Social Worker127896CA

General Provider Information

NPI Number : 1700436383
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE TERRAS MOORE LCSW
Provider Business Mailing Address
First Line : 1360 S ANAHEIM BLVD STE 101
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6258
Country : US
Telephone Number : 714-948-7641
Fax Number :
Provider Business Practice Location Address
First Line : 1360 S ANAHEIM BLVD STE 101
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6258
Country : US
Telephone Number : 714-948-7641
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2019
Last Update Date : 05/13/2025

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Directions to “ MELANIE TERRAS MOORE LCSW” Practice Location

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