Provider Demographics
NPI:1669860599
Name:MOOSE, CLAUDIA (ATC, CSCS, PMA-CPT)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:MOOSE
Suffix:
Gender:F
Credentials:ATC, CSCS, PMA-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3658 MT DIABLO BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-6885
Mailing Address - Country:US
Mailing Address - Phone:925-299-9642
Mailing Address - Fax:
Practice Address - Street 1:3658 MT DIABLO BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-6885
Practice Address - Country:US
Practice Address - Phone:925-299-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer