Provider Demographics
NPI:1043908205
Name:MOORE, JANENE KINGSLEY (LMFT)
Entity type:Individual
Prefix:
First Name:JANENE
Middle Name:KINGSLEY
Last Name:MOORE
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:JANENE
Other - Middle Name:
Other - Last Name:KINGSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8035 MADISON AVE STE A4
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7949
Mailing Address - Country:US
Mailing Address - Phone:916-257-2274
Mailing Address - Fax:
Practice Address - Street 1:8035 MADISON AVE STE A4
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7949
Practice Address - Country:US
Practice Address - Phone:916-257-2274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT136024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health