Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Ryan Moore

Individual provider Licensed Vocational Nurse · NPI 1346008844

Jacob Ryan Moore is a Licensed Vocational Nurse in Fair Oaks, California. Licensed in California. Registered with an NPI since 2024.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

10821 Fair Oaks Blvd
Fair Oaks, CA 95628-7214
Phone: (916) 903-7028
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Vocational Nurse (primary) Taxonomy 164X00000X · Licence 722770 (CA)

Record details

NPI number1346008844
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 8, 2024
Last updated in NPPESMarch 8, 2024
Certification dateMarch 7, 2024
Mailing address2609 K St Apt 11, Sacramento, CA 95816-5112

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