Provider Demographics
NPI:1891020293
Name:MOYE-DANIEL, SARAH L
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:MOYE-DANIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 BANCROFT AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-2059
Mailing Address - Country:US
Mailing Address - Phone:562-577-9756
Mailing Address - Fax:
Practice Address - Street 1:900 5TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2928
Practice Address - Country:US
Practice Address - Phone:415-457-6964
Practice Address - Fax:415-457-1929
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner