Provider Demographics
NPI:1831846567
Name:MOORE, REBECCA JEAN HORSPOOL
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN HORSPOOL
Last Name:MOORE
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 1:22475 QUAIL CALL DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-1100
Mailing Address - Country:US
Mailing Address - Phone:195-133-3754
Mailing Address - Fax:
Practice Address - Street 1:22475 QUAIL CALL DR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-1100
Practice Address - Country:US
Practice Address - Phone:195-133-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist