Provider Demographics
NPI:1104586700
Name:MORELAND, EMMA BELLE (LM, CPM)
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:BELLE
Last Name:MORELAND
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 TELEGRAPH CANYON RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-6471
Mailing Address - Country:US
Mailing Address - Phone:318-843-4418
Mailing Address - Fax:
Practice Address - Street 1:3633 CAMINO DEL RIO S STE 206
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4014
Practice Address - Country:US
Practice Address - Phone:318-843-4418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM662176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife