Provider Demographics
NPI:1003051947
Name:MOORE-RACHED, PAMELA
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:MOORE-RACHED
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:RACHED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5320 DORADO CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92509-5873
Mailing Address - Country:US
Mailing Address - Phone:951-684-2068
Mailing Address - Fax:951-684-2066
Practice Address - Street 1:5320 DORADO CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-5873
Practice Address - Country:US
Practice Address - Phone:951-684-2068
Practice Address - Fax:951-684-2066
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)