Provider Demographics
NPI:1841701422
Name:MOYO, NHLANHLA (PMHNP- BC)
Entity type:Individual
Prefix:MR
First Name:NHLANHLA
Middle Name:
Last Name:MOYO
Suffix:
Gender:M
Credentials:PMHNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 DI LUSSO DR APT 133
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5885
Mailing Address - Country:US
Mailing Address - Phone:916-262-4890
Mailing Address - Fax:916-244-4824
Practice Address - Street 1:3301 37TH STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824
Practice Address - Country:US
Practice Address - Phone:916-210-8773
Practice Address - Fax:916-395-5904
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95094023163W00000X
CA95012918363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health