Active NPI
Tarron Phillips
- Marriage & Family Therapist
- Moreno Valley, CA
National Provider Identifier
1093198442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 96514
- Practice address
- 24040 Postal Ave Unit 204
Moreno Valley, CA 92556-5010 - Phone
- (951) 500-7264
- NPI assigned
- Jul 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 96514 | CA | Primary |
| Marriage & Family Therapist | 106H00000X | 83466 | CA |
Addresses
Primary practice location
24040 Postal Ave Unit 204
Moreno Valley, CA 92556-5010
Mailing address
24040 Postal Ave Unit 204
Moreno Valley, CA 92556-5010
Phone (951) 500-7264
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96514 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1093198442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24040 POSTAL AVE UNIT 204",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925565010",
"telephone_number": "951-500-7264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24040 POSTAL AVE UNIT 204",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925565010",
"telephone_number": "951-500-7264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TARRON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-02",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "96514",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "83466",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.