Shawn Albert Moore

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

146232 Issued in CA

Practice address

4600 47TH Ave
Sacramento, CA 95824-3923

Phone

(916) 940-7094

Fax

(510) 569-4589

NPI assigned

Aug 15, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• IA HMO
• IA HMO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1033518071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 47TH AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958243923",
            "telephone_number": "916-501-4378",
            "fax_number": "510-569-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 47TH AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958243923",
            "telephone_number": "916-940-7094",
            "fax_number": "510-569-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHAWN",
        "middle_name": "ALBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-15",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "146232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rob Moore, PHD, MSW, MSP, CADC
• Sara Alice Moore, MFT
• Sarah Elyse Moore, OTR/L
• Shanika Tyann Moore
• Shanna Marie Moore
• Sherika O Moore
• Sierra Moore
• Stacey Moore
• Tiffany Moore
• Tiffany Iesha Moore

• Marriage & Family Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.