Organization
THE STEPPING STONES AUTISM GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS R MOES PH.D. (PRESIDENT, CEO)
(805) 915-9912
Entity
Organization
Contact information
Practice address
225 SAN MATTEO ST, GEORGETOWN, TX 78628-7032
(805) 791-4219
Mailing address
4880 MARKET ST, VENTURA, CA 93003-7783
(805) 915-9912
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY16222
PSY
CA
Enumeration date
09/07/2018
Last updated
01/31/2020
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