| Doctor Name: | MR. PAO L. MOUA |
| NPI Number: | 1104126077 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 500 Jefferson Blvd Bldg. B, Suite 150 West Sacramento, CA - 956052350 |
| Business Phone Number: | 9163768591 |
| Business Fax Number: | 9163768595 |
| Mailing Address: | 12310 Montauk Way, RANCHO CORDOVA |
| State: | CA |
| Postal Code: | 957427724 |
| Phone Number: | 9168335471 |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2010 |
| NPI Last Update Date: | 10/26/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |