Moore, Amanda

Moore, Amanda is an sole proprietor health care provider with primary practice located at 634 Pressley St , Santa Rosa CA 95404-5526. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Moore, Amanda can be contacted via phone (707) 573-6955.

Contact Information

Primary practice address
634 Pressley St Santa Rosa CA 95404-5526
Phone: (707) 573-6955
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1194196139
LBN Legal business name Moore, Amanda
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 16th, 2015
Last updated Oct 16th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194196139 NPPES
California Other 1954 MEDI-CAL

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