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STEPHANIE MOORE PSYD

Clinical Neuropsychologist

Santa Ana, California

Provider NPI: 1225032865

Provider Information:
 STEPHANIE  MOORE PSYD
Gender: F
Sole Proprietor


Practice Location:
801 N TUSTIN AVE #603 SANTA ANA, CA 92705 US
Tel: 714-731-6231  Fax: 714-731-6283

Business Mailing Address:
24992 KATIE AVE  LAGUNA HILLS, CA 92053 US
Tel: 949-280-7984  Fax: 949-474-1174

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
CAPSY14222

Other Provider Identifiers:

IssuerNumberStateType
LICENSEPSY14222CA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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