Provider Demographics
NPI:1629114319
Name:MOEUN, VIRIYA (HIGH SCHOOL DIPLOMA)
Entity type:Individual
Prefix:MISS
First Name:VIRIYA
Middle Name:
Last Name:MOEUN
Suffix:
Gender:F
Credentials:HIGH SCHOOL DIPLOMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N. FIRST STREET
Mailing Address - Street 2:MOMENTUM FOR HEALTH
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112
Mailing Address - Country:US
Mailing Address - Phone:669-213-1795
Mailing Address - Fax:
Practice Address - Street 1:540 N. FIRST STREET
Practice Address - Street 2:MOMENTUM FOR HEALTH
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112
Practice Address - Country:US
Practice Address - Phone:669-213-1795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner