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Individual
GEORGE MORENO
Active
Individual
GEORGE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC-II, DDCS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A051120118
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A051120118
CCAPP
CA
Enumeration date
05/08/2018
Last updated
06/16/2018
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