Provider Demographics
NPI:1013363522
Name:THE J. MOSS FOUNDATION
Entity Type:Organization
Organization Name:THE J. MOSS FOUNDATION
Other - Org Name:SKINNY GENE PROJECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLAYNA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:BOLLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-793-2010
Mailing Address - Street 1:10620 TREENA ST
Mailing Address - Street 2:230
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1140
Mailing Address - Country:US
Mailing Address - Phone:619-793-2010
Mailing Address - Fax:858-408-1891
Practice Address - Street 1:10620 TREENA ST
Practice Address - Street 2:230
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1140
Practice Address - Country:US
Practice Address - Phone:619-793-2010
Practice Address - Fax:858-408-1891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public HealthGroup - Single Specialty