Jacob Moulds, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A18277 Issued in CA

Practice address

3061 Fillmore St
San Francisco, CA 94123-4009

Phone

(415) 292-3440

NPI assigned

Feb 16, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1003275264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 FILLMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234009",
            "telephone_number": "415-292-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 FILLMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234009",
            "telephone_number": "415-292-3440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7031 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "South Miami",
            "state": "FL",
            "postal_code": "331434701",
            "country_code": "US",
            "telephone_number": "305-284-7761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULDS",
        "first_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-16",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS16307",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A18277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pang Tao Moua, PHD
• Regina Nguyen Moua
• Armen Jirair Moughamian, MD
• Taleen Moughamian, CRNP
• Sarah Moulding, L.C.S.W.
• Kendall Edward Moulds, NP
• Mount Saint Joseph and Elizabeth
• Mount St Joseph
• Mount St. Joseph-St. Elizabeth
• Mount St. Joseph-St. Elizabeth

• Psychiatry Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.