Individual
CYRUS A MOAZAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9267 GREENBACK LN, B-98, ORANGEVALE, CA 95662-4863
(916) 505-9151
(916) 988-7864
Mailing address
767 HERITAGE PL, FOLSOM, CA 95630-6242
(916) 505-9151
(916) 988-7864
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY13748
CA
103TB0200X
Cognitive & Behavioral Psychologist
Primary
PSY13748
CA
103TC0700X
Clinical Psychologist
PSY13748
CA
103TC1900X
Counseling Psychologist
PSY13748
CA
103TF0200X
Forensic Psychologist
PSY13748
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PSY13748
CA
Other
Enumeration date
05/07/2007
Last updated
04/20/2012
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