ETHEL FAY MOORE (NPI# 1104944792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104944792 |
Entity Type | Individual |
Full Name | ETHEL FAY MOORE |
Credential | CPRP |
Practice Address |
43423 Division St Ste 107 Lancaster CA 93535-4640 |
Mailing Address |
14575 Stonecress St Victorville CA 92394-7021 |
Practice Telephone | 6617262850 |
Practice Fax Number | 6617262854 |
Enumeration Date | 2007-03-26 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 225400000X | Rehabilitation Practitioner | NA | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
X | 171M00000X | Case Manager/Care Coordinator | NA | CA | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750634721 | Ethel Moore | Counselor | 3821 Little York Rd, Dayton, OH 45414-2409 | 2012-10-16 |
1053437079 | Ethel Lamar Moore | Family Medicine | Rr 1 Box 67, Harlem, MT 59526-9705 | 2007-03-21 |
Street Address |
43423 DIVISION ST STE 107 |
City | LANCASTER |
State | CA |
Zip Code | 93535-4640 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285751404 | Bobbie Dale Staats | Rehabilitation Practitioner | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-03-23 |
1114162112 | Bernice Oguin Osborn | Case Manager/Care Coordinator | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2008-12-05 |
1962601674 | Jessica Lea Bones | Case Manager/Care Coordinator | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-07-12 |
1841498243 | James V Holzer I | Case Manager/Care Coordinator | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-07-06 |
1790805547 | Cathy Reilly | Rehabilitation Practitioner | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-03-29 |
1114046620 | Guyton Colantuono | Case Manager/Care Coordinator | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-03-28 |
1164541462 | Alexa B. Brown | Licensed Vocational Nurse | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-03-28 |
1093832610 | Natalie Emerald Holcomb | Case Manager/Care Coordinator | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-03-26 |
1821115452 | James Lake | Rehabilitation Practitioner | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-03-26 |
1922126267 | Jeannine Herron | Rehabilitation Practitioner | 43423 Division St Ste 107, Lancaster, CA 93535-4640 | 2007-03-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003464793 | Lovernie Arenque Pilarca | Technician | 42952 Yaffa St, Lancaster, CA 93535 | 2019-08-27 |
1528565934 | Danelly Luna | Behavioral Analyst | 340 E Avenue Suite 101, Lancaster, CA 93535 | 2018-04-11 |
1841791456 | Mary Sowah-quaye | Social Worker | 1326 East Cambridge Court, Lancaster, CA 93535 | 2018-02-28 |
1497272231 | Monica Arellano | Behavioral Analyst | 40526 176th St. E, Lancaster, CA 93535 | 2017-08-23 |
1679920227 | Kristina Doronila Gaddi | Licensed Vocational Nurse | 1308 East Cambridge Ct, Lancaster, CA 93535 | 2016-05-24 |
1558720839 | Eric Washington | Student in an Organized Health Care Education/Training Program | 43625 San Francisco Ave., Lancaster, CA 93535 | 2016-02-16 |
1215309935 | Anita Maria Hill | Registered Nurse | 44545 3rd Street E., Lancaster, CA 93535 | 2015-10-21 |
1538568548 | Roman Flores | Marriage & Family Therapist | 43520 Division St., Lancaster, CA 93535 | 2014-08-14 |
1083045496 | Wanda Elaine Smith | Assisted Living Facility | 1046 E. Lancaster Blvd, Lancaster, CA 93535 | 2013-12-11 |
1841624046 | Jennifer Lagare Hagerty | Nurse Practitioner | 335 East Avenue I, Lancaster, CA 93535 | 2013-08-25 |
Find all providers in zip 93535 |
Taxonomy Code | 225400000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Rehabilitation Practitioner |
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518442672 | Mayra Castillo | Rehabilitation Practitioner | 921 W Avenue J Ste J, Lancaster, CA 93534-3443 | 2018-09-25 |
1518476928 | Rennie Roshell Euwing | Rehabilitation Practitioner | 45043 Sierra Hwy # A, Lancaster, CA 93534-2519 | 2017-09-28 |
1194033209 | Rovinson Rapisora De Guzman | Rehabilitation Practitioner | 43721 Maplewood St, Lancaster, CA 93535-6130 | 2010-09-23 |
1114241445 | Alyna Chanel Gutierrez | Rehabilitation Practitioner | 504 W.jackman St, Lancaster, CA 93534 | 2010-03-15 |
1033346515 | Sonia Carrillo | Rehabilitation Practitioner | 45111 N. Fern Ave, Lancaster, CA 93534 | 2009-06-11 |
1164657334 | Alma Lee Payne | Rehabilitation Practitioner | 44300 Lowtree Ave Ste 106, Lancaster, CA 93534-4171 | 2009-05-18 |
1568601730 | Manuel Perez | Rehabilitation Practitioner | 506 West Jackman, Lancaster, CA 93534 | 2009-02-12 |
1548425291 | Jessica Marisol Moran | Rehabilitation Practitioner | 45111 N. Fern Ave., Lancaster, CA 93534 | 2008-07-22 |
1972767424 | Francisco Villeda | Rehabilitation Practitioner | 45550 Pickford Ave, Lancaster, CA 93534-1379 | 2008-07-14 |
1639364425 | Llanet Liliana Acosta | Rehabilitation Practitioner | 43423 Division St., Lancaster, CA 93535-4089 | 2007-09-13 |
Find all providers in LANCASTER |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.