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NPI Code Detail

MEDICARE: MS. PATRICIA ANN MORENO

MEDICARE: MS. PATRICIA ANN MORENO
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 Worker95061CA

General Provider Information

NPI Number : 1841336948
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA ANN MORENO
Provider Business Mailing Address
First Line : 7707 AUSTIN RD
Second Line :
City : STOCKTON
State : CA
Zip : 95215-8312
Country : US
Telephone Number : 209-467-1293
Fax Number :
Provider Business Practice Location Address
First Line : 7707 AUSTIN RD
Second Line :
City : STOCKTON
State : CA
Zip : 95215-8312
Country : US
Telephone Number : 209-467-1293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 06/07/2022

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Directions to “ MS. PATRICIA ANN MORENO ” Practice Location

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