Provider Demographics
NPI:1235029745
Name:MOSES, SHAKEYA DENEASIA
Entity type:Individual
Prefix:
First Name:SHAKEYA
Middle Name:DENEASIA
Last Name:MOSES
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 1:373 W AVENUE J8
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5066
Mailing Address - Country:US
Mailing Address - Phone:323-394-3735
Mailing Address - Fax:
Practice Address - Street 1:373 W AVENUE J8
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5066
Practice Address - Country:US
Practice Address - Phone:323-394-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF7584976343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)