Provider Demographics
NPI:1639316375
Name:MOORE, LORIE ANN
Entity type:Individual
Prefix:
First Name:LORIE
Middle Name:ANN
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 1:12523 LIMONITE AVE STE 440-310
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752-3665
Mailing Address - Country:US
Mailing Address - Phone:951-367-8378
Mailing Address - Fax:951-281-0307
Practice Address - Street 1:12523 LIMONITE AVE UNIT 440-310
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:91752-3665
Practice Address - Country:US
Practice Address - Phone:951-367-8378
Practice Address - Fax:951-281-0307
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor