Provider Demographics
NPI:1902613557
Name:CONTEH-GARNETT, MOORE FATMATA
Entity type:Individual
Prefix:
First Name:MOORE
Middle Name:FATMATA
Last Name:CONTEH-GARNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 N MARKET ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95113-1211
Mailing Address - Country:US
Mailing Address - Phone:510-210-3233
Mailing Address - Fax:
Practice Address - Street 1:2 N MARKET ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1211
Practice Address - Country:US
Practice Address - Phone:510-210-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95351981163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health