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Individual
JACOB ROBERT MOORE
Active
Individual
JACOB ROBERT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
540031BN
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1629650825
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RT1452360826
CA
Other
Enumeration date
02/19/2026
Last updated
08/06/2026
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