Provider Demographics
NPI:1326450388
Name:MOU, DAMING (MS & MA)
Entity Type:Individual
Prefix:MRS
First Name:DAMING
Middle Name:
Last Name:MOU
Suffix:
Gender:F
Credentials:MS & MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-6142
Mailing Address - Country:US
Mailing Address - Phone:925-513-1122
Mailing Address - Fax:
Practice Address - Street 1:231 OLD BERNAL AVE STE 7
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7015
Practice Address - Country:US
Practice Address - Phone:925-207-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT113368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist