Provider Demographics
NPI:1720556780
Name:MOSES, MONIQUE CHERIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:CHERIE
Last Name:MOSES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 ARCATA DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-5591
Mailing Address - Country:US
Mailing Address - Phone:702-401-8113
Mailing Address - Fax:
Practice Address - Street 1:7065 INDIANA AVE STE 110
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4167
Practice Address - Country:US
Practice Address - Phone:951-476-0115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR265297363L00000X
DC500017534363L00000X
VA0024189990363L00000X
HIAPRN-4607363L00000X
OR10023053363L00000X
NM78346363L00000X
TX1155158363L00000X
FLTPAN2152363L00000X
ID75279363L00000X
UT13199295-8900363L00000X
NV814746363LF0000X
CA95023706363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily