Provider Demographics
NPI:1235957820
Name:MOSELEY, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:MOSELEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1167
Mailing Address - Street 2:
Mailing Address - City:WOFFORD HTS
Mailing Address - State:CA
Mailing Address - Zip Code:93285-1167
Mailing Address - Country:US
Mailing Address - Phone:818-723-6080
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2632
Practice Address - Street 2:
Practice Address - City:LAKE ISABELLA
Practice Address - State:CA
Practice Address - Zip Code:93240-2632
Practice Address - Country:US
Practice Address - Phone:760-379-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty