Individual
DIANE A. MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
5900 HOLLIS ST STE J, EMERYVILLE, CA 94608-2008
(501) 648-9496
Mailing address
5900 HOLLIS ST STE J, EMERYVILLE, CA 94608-2008
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY9439
CA
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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