Provider Demographics
NPI:1164657276
Name:MOORE-JONES, PAMELA RENE' (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:RENE'
Last Name:MOORE-JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:RENE'
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:40 BAY SHORE AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3498
Mailing Address - Country:US
Mailing Address - Phone:951-249-4501
Mailing Address - Fax:
Practice Address - Street 1:1600 E FLORIDA AVE STE 209
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-8648
Practice Address - Country:US
Practice Address - Phone:951-249-4500
Practice Address - Fax:951-658-1253
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS254621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical