Provider Demographics
NPI:1558678961
Name:MORIANA, JOHN NICHOLAS (#ASW88795)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:NICHOLAS
Last Name:MORIANA
Suffix:
Gender:M
Credentials:#ASW88795
Other - Prefix:
Other - First Name:NICK
Other - Middle Name:
Other - Last Name:MORIANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:#ASW88795
Mailing Address - Street 1:3727 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6134
Mailing Address - Country:US
Mailing Address - Phone:925-713-2156
Mailing Address - Fax:925-713-2157
Practice Address - Street 1:3727 SUNSET LN
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6134
Practice Address - Country:US
Practice Address - Phone:415-641-8000
Practice Address - Fax:415-641-8002
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW887951041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical