Individual
ANDREA G MOORE-EMMETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
9330 BASELINE RD STE 102, RANCHO CUCAMONGA, CA 91701
(909) 303-0960
(877) 560-5695
Mailing address
9330 BASELINE RD STE 102, RANCHO CUCAMONGA, CA 91701-5827
(909) 303-0960
(877) 560-5695
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
97170
CA
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
97170
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164739595
—
CA
Enumeration date
09/07/2010
Last updated
08/31/2018
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