Individual
JESSICA MOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW 67422
Contact information
Practice address
12450 VAN NUYS BLVD, SUITE 200, PACOIMA, CA 91331-1391
(818) 896-1161
(818) 896-5069
Mailing address
12450 VAN NUYS BLVD, SUITE 200, PACOIMA, CA 91331-1391
(818) 896-1161
(818) 896-5069
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
67422
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6758
—
CA
05
—
7068
—
CA
05
—
7420
—
CA
Enumeration date
06/13/2014
Last updated
07/05/2016
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