Individual
MR. ANDY R MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFTI, RASI
Contact information
Practice address
7790 BIG ROCK DR., RIVERSIDE, CA 92509
(951) 500-4497
Mailing address
7790 BIG ROCK DR., RIVERSIDE, CA 92509
(951) 500-4497
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
RI-M1305212002
CA
106H00000X
Marriage & Family Therapist
Primary
IMF 65612
CA
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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