Individual
ESSENCE TIERRA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6228 MANZANITA WAY, RIVERSIDE, CA 92504-1786
(909) 382-1408
Mailing address
6228 MANZANITA WAY, RIVERSIDE, CA 92504-1786
(909) 382-1408
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
CA
146N00000X
Basic Emergency Medical Technician
Primary
E178159
CA
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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