Individual
CINTA LATRECE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12329 CREEKVIEW DR UNIT 37, SAN DIEGO, CA 92128-6624
(661) 378-2789
Mailing address
13308 MIDLAND RD UNIT 9, POWAY, CA 92074-7002
(951) 837-9532
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7665830
DRIVER LICENSE
CA
Enumeration date
09/10/2020
Last updated
09/10/2020
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