Individual provider · Type 1 NPI

Kelly Moore

Student in an Organized Health Care Education/Training Program · Camarillo, CA

NPI number 1528510385 Active

Practice location

4000 Calle Tecate Ste 117
Camarillo, CA 93012-5285

Call (805) 383-0470 Map

Mailing address

135 Camino Ruiz Apt 143
Camarillo, CA 93012-6757

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Athletic Trainer 2255A2300XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1528510385

Kelly Moore's National Provider Identifier is 1528510385, issued on Oct 27, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Camarillo, CA. The record was last updated on Oct 22, 2026.