Individual provider Active NPI

Christina Moran

  • Psychologist
  • San Diego, CA
National Provider Identifier
1063661577
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY25925 Issued in CA
Practice address
4550 Kearny Villa Rd Ste 221
San Diego, CA 92123-1557
Phone
(619) 616-1911
NPI assigned
Sep 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY25925 CA Primary

Addresses

Primary practice location

4550 Kearny Villa Rd Ste 221
San Diego, CA 92123-1557

Mailing address

4550 Kearny Villa Rd Ste 221
San Diego, CA 92123-1557
Phone (619) 616-1911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241016004764 CA Practitioner - Clinical Psychologist 9931631843 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY25925CAMDPsychologist
25925CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare CurrentSince Oct 7, 2024 Accepting new patients
Neighborhood Healthcare CurrentSince Oct 7, 2024 Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

215 S Hickory St
Escondido, CA 92025
Phone (619) 354-3833

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1063661577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD STE 221",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231557",
            "telephone_number": "619-616-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD STE 221",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231557",
            "telephone_number": "619-616-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY25925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.