Provider Demographics
NPI:1013622620
Name:MOSESMAN, YOLANDA CARMELA (RAC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:CARMELA
Last Name:MOSESMAN
Suffix:
Gender:F
Credentials:RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MARINA BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-2102
Mailing Address - Country:US
Mailing Address - Phone:925-427-9100
Mailing Address - Fax:
Practice Address - Street 1:535 MARINA BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-2102
Practice Address - Country:US
Practice Address - Phone:925-427-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15887101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)