MEDICARE: RICKI MOULTON

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	1041C0700X	Clinical Social Worker	125554	CA

General Provider Information

NPI Number	:	1972006997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICKI MOULTON

Provider Business Mailing Address
First Line	:	711 G ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-1212
Country	:	US
Telephone Number	:	916-639-7522
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 G ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-1212
Country	:	US
Telephone Number	:	916-639-7522
Fax Number	:

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

Provider Enumeration Date	:	03/15/2018
Last Update Date	:	03/24/2026

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Directions to “ RICKI MOULTON ” Practice Location

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