Individual
JACOB JOSEPH MOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TECH
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(888) 376-6246
Mailing address
5363 N FRESNO ST STE 105, FRESNO, CA 93710-6848
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
10/04/2022
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