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

Stella Moon

Individual provider Occupational Therapy Assistant · NPI 1578184628

Stella Moon is an Occupational Therapy Assistant in Santa Rosa, California. Licensed in California. Registered with an NPI since 2020.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

320 Tesconi Cir Ste G
Santa Rosa, CA 95401-4611
Phone: (707) 544-2637
Fax: (707) 544-2088
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Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence OTA2154 (CA)

Record details

NPI number1578184628
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 29, 2020
Last updated in NPPESApril 29, 2020
Certification dateApril 29, 2020
Mailing address320 Tesconi Cir Ste G, Santa Rosa, CA 95401-4611

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