Provider Demographics
NPI:1972797819
Name:MOORE, APRIL KIMBERLY (RRW)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:KIMBERLY
Last Name:MOORE
Suffix:
Gender:F
Credentials:RRW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 RIMPAU AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-5724
Mailing Address - Country:US
Mailing Address - Phone:951-549-8888
Mailing Address - Fax:951-549-8808
Practice Address - Street 1:710 RIMPAU AVE STE 102
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-5724
Practice Address - Country:US
Practice Address - Phone:951-549-8888
Practice Address - Fax:951-549-8808
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARW1021101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)