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Individual

ENRICA MORENO MABULAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
16500 VENTURA BLVD STE 414, ENCINO, CA 91436-5050
(818) 788-1003
Mailing address
14031 ASTORIA ST UNIT 106, SYLMAR, CA 91342-2984
(701) 797-7161

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
250102243
CA

Other

Enumeration date
01/08/2026
Last updated
01/08/2026
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