Provider Demographics
NPI:1285061440
Name:MOYA, DELINA MARIE (CAS)
Entity type:Individual
Prefix:
First Name:DELINA
Middle Name:MARIE
Last Name:MOYA
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9913 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2301
Mailing Address - Country:US
Mailing Address - Phone:818-273-4692
Mailing Address - Fax:818-273-4752
Practice Address - Street 1:9913 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2301
Practice Address - Country:US
Practice Address - Phone:818-273-4692
Practice Address - Fax:818-273-4752
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01135228101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)