Individual provider Active NPI

Raquel Magdalena Moran, M.A

  • Mental Health Counselor
  • San Bernardino, CA
National Provider Identifier
1063782977
Registry record updated Aug 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1950 South Sunwest Lane
San Bernardino, CA 92415
Phone
(909) 252-4010
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1950 South Sunwest Lane
San Bernardino, CA 92415

Mailing address

1950 South Sunwest Lane
San Bernardino, CA 92415
Phone (909) 252-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1063782977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SOUTH SUNWEST LANE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92415",
            "telephone_number": "909-252-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SOUTH SUNWEST LANE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92415",
            "telephone_number": "909-252-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "RAQUEL",
        "middle_name": "MAGDALENA",
        "name_prefix": "Miss",
        "credential": "M.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.