Provider Demographics
NPI:1437466893
Name:MOORE, CASSANDRA JEAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:JEAN
Last Name:MOORE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4667 MACARTHUR BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1867
Mailing Address - Country:US
Mailing Address - Phone:949-400-4099
Mailing Address - Fax:
Practice Address - Street 1:4667 MACARTHUR BLVD STE 320
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1867
Practice Address - Country:US
Practice Address - Phone:949-400-4099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health