Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY 16193 | CA |
N | 103G00000X | Clinical Psychologist | PSY 16193 | CA |
N | 103TC0700X | Clinical Psychologist | PSY 16193 | CA |
N | 103TH0100X | Health Service | PSY 16193 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY 16193 | CA |
NPI | 1477573608 |
---|---|
Provider Name | Dr. Steven H. Moss |
First Address | Pasadena, CA 91101-2039 |
Second Address | Pasadena, CA 91101-2039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |