Individual
JEFF MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 VERMOUNT AVE, LOS ANGELES, CA 90023
(818) 610-6764
Mailing address
6800 OWENSMOUTH AVE, CANOGA PARK, CA 91303-3159
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
LMFT89420
CA
Other
Enumeration date
08/18/2017
Last updated
06/16/2018
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