| Jennifer Moynihan, Licensed Clinical Social Worker, Inc. | |
|
9815 Carroll Canyon Rd Ste 101 San Diego CA 92131-1123 | |
| (858) 284-0336 | |
| Not Available |
| Full Name | Jennifer Moynihan, Licensed Clinical Social Worker, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 9815 Carroll Canyon Rd Ste 101, San Diego, California |
| Authorized Official Name and Position | Jennifer Leigh Moynihan (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8582840336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Moynihan, Licensed Clinical Social Worker, Inc. 9815 Carroll Canyon Rd Ste 101 San Diego CA 92131-1123 Ph: (858) 284-0336 | Jennifer Moynihan, Licensed Clinical Social Worker, Inc. 9815 Carroll Canyon Rd Ste 101 San Diego CA 92131-1123 Ph: (858) 284-0336 |
| NPI Number | 1164115507 |
|---|---|
| Provider Enumeration Date | 05/31/2023 |
| Last Update Date | 05/31/2023 |
| Certification Date | 05/31/2023 |
| Medicare PECOS PAC ID | 1850751033 |
|---|---|
| Medicare Enrollment ID | O20230719002916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164115507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Moynihan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538187638 PECOS PAC ID: 5294743860 Enrollment ID: I20060323000826 |
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