Individual
CHARLES E. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RASI
Contact information
Practice address
820 23RD ST, RICHMOND, CA 94804-1338
(510) 229-5000
(510) 235-3112
Mailing address
398 S 34TH ST, RICHMOND, CA 94804-3120
(510) 237-8073
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RI-M0501060833
CA
Other
Enumeration date
05/08/2007
Last updated
02/06/2008
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