Provider Demographics
NPI:1376602219
Name:MORAN, JAMES PAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PAUL
Last Name:MORAN
Suffix:
Gender:M
Credentials:PHD
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VETERANS BLVD FL 2
Mailing Address - Street 2:CHRONIC PAIN PROGRAM, RWC-KAISER
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2612
Mailing Address - Country:US
Mailing Address - Phone:650-299-4772
Mailing Address - Fax:650-299-4791
Practice Address - Street 1:1400 VETERANS BLVD FL 2
Practice Address - Street 2:CHRONIC PAIN PROGRAM, RWC-KAISER
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2612
Practice Address - Country:US
Practice Address - Phone:650-299-4772
Practice Address - Fax:650-299-4791
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY8045103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service