Provider Demographics
NPI:1487778171
Name:MOSES, REBECCA MARIE (MA, MFTI)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:MOSES
Suffix:
Gender:F
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 S LA CIENEGA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2520
Mailing Address - Country:US
Mailing Address - Phone:310-855-0031
Mailing Address - Fax:
Practice Address - Street 1:1233 S LA CIENEGA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2520
Practice Address - Country:US
Practice Address - Phone:310-855-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator