Individual provider Active NPI

Andra Marcela Alexandra Moldav

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1023738994
Registry record updated Apr 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
162849 Issued in CA
Practice address
840 N Avenue 66
Los Angeles, CA 90042-1508
Phone
(626) 395-7100
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 162849 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

840 N Avenue 66
Los Angeles, CA 90042-1508

Mailing address

PO Box 421528
Los Angeles, CA 90042-0528
Phone (347) 204-0772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 24, 2026 through Apr 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
162849CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776556800000",
    "number": "1023738994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421528",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900420528",
            "telephone_number": "347-204-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N AVENUE 66",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421508",
            "telephone_number": "626-395-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDAV",
        "first_name": "ANDRA MARCELA",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "162849",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.