Provider Demographics
NPI:1003412602
Name:MOXEY, MAHALA MAJIDA (DPT)
Entity Type:Individual
Prefix:DR
First Name:MAHALA
Middle Name:MAJIDA
Last Name:MOXEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4287 VENTAVO RD # B
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-9725
Mailing Address - Country:US
Mailing Address - Phone:402-450-9187
Mailing Address - Fax:
Practice Address - Street 1:2001 SOLAR DR STE 180
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2647
Practice Address - Country:US
Practice Address - Phone:805-604-7364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist