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Individual
JENNIFER E MOORE
Active
Individual
JENNIFER E MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63807
ASSOCIATE CLINICAL SOCIAL WORKER ASW
CA
01
—
LCSW84186
LICENSED CLINICAL SOCIAL WORKER
CA
Enumeration date
11/06/2009
Last updated
02/14/2020
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