Provider Demographics
NPI:1427931187
Name:MOYA, JEFFREY RICHARD
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:RICHARD
Last Name:MOYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 30TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4232
Mailing Address - Country:US
Mailing Address - Phone:843-754-2027
Mailing Address - Fax:
Practice Address - Street 1:4451 30TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-4232
Practice Address - Country:US
Practice Address - Phone:619-914-2391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program