Individual provider · Type 1 NPI

Ethel Fay Moore, CPRP

Rehabilitation Practitioner · Lancaster, CA

NPI number 1104944792 Active

Practice location

43423 Division St Ste 107
Lancaster, CA 93535-4640

Call (661) 726-2850 Map

Fax (661) 726-2854

Mailing address

14575 Stonecress St
Victorville, CA 92394-7021

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNA (CA)
Rehabilitation Practitioner Primary 225400000XNA (CA)

Rehabilitation Practitioner: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

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About NPI 1104944792

Ethel Fay Moore, CPRP's National Provider Identifier is 1104944792, issued on Mar 26, 2007. The primary taxonomy on file is Rehabilitation Practitioner (225400000X), and the practice location is in Lancaster, CA. The record was last updated on Sep 11, 2025.