Doctor Name: | DR. EMILIA MORENO |
NPI Number: | 1942551064 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D |
License Number: | CA LIC PSY24145 |
Business Practice Address: | 1235 Mission St San Francisco, CA - 941032705 |
Business Phone Number: | 5106459625 |
Business Fax Number: | |
Mailing Address: | Po Box 16188, OAKLAND |
State: | CA |
Postal Code: | 946106188 |
Phone Number: | 5106459625 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2012 |
NPI Last Update Date: | 07/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | CA LIC PSY24145 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |