Individual provider Active NPI

Christine E Moon, LMFT

  • Marriage & Family Therapist
  • Saratoga, CA
National Provider Identifier
1013566587
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
88025 Issued in CA
Practice address
20688 4TH St # 3
Saratoga, CA 95070-5894
Phone
(408) 857-5687
NPI assigned
Sep 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 88025 CA Primary

Addresses

Primary practice location

20688 4TH St # 3
Saratoga, CA 95070-5894

Mailing address

PO Box 110183
Campbell, CA 95011-0183
Phone (408) 482-7605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 25, 2024 through Mar 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
88025CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1013566587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110183",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950110183",
            "telephone_number": "408-482-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20688 4TH ST # 3",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950705894",
            "telephone_number": "408-857-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "CHRISTINE",
        "middle_name": "E",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "88025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, CA

Sources for this page

Verify at the official NPI Registry.