Individual
DR. JOSEPH KELLY MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6642 BELLEVUE ORCHARD LN, SAN LUIS OBISPO, CA 93405-8067
(805) 756-2805
(805) 756-1134
Mailing address
6642 BELLEVUE ORCHARD LN, SAN LUIS OBISPO, CA 93405-8067
(805) 756-2805
(805) 756-1134
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
4940521-2501
UT
103TF0200X
Forensic Psychologist
Primary
PSY 13000
CA
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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