Provider Demographics
NPI:1649061169
Name:PLAYFUL EXPRESSIONS CHILD AND FAMILY THERAPY
Entity type:Organization
Organization Name:PLAYFUL EXPRESSIONS CHILD AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:619-634-7537
Mailing Address - Street 1:PO BOX 2763
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91979-2763
Mailing Address - Country:US
Mailing Address - Phone:619-634-7537
Mailing Address - Fax:
Practice Address - Street 1:5480 BALTIMORE DR STE 207
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2003
Practice Address - Country:US
Practice Address - Phone:619-634-7537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty