Provider Demographics
NPI:1376337311
Name:MOYA, VIKI JASMINE
Entity type:Individual
Prefix:
First Name:VIKI
Middle Name:JASMINE
Last Name:MOYA
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 1:145 E SPRING ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1524
Mailing Address - Country:US
Mailing Address - Phone:562-850-5474
Mailing Address - Fax:
Practice Address - Street 1:6060 N PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-3711
Practice Address - Country:US
Practice Address - Phone:562-630-8672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program