Active NPI
Andra Marcela Alexandra Moldav
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1023738994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 162849
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 162849 | CA | MD | Marriage & 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.