Individual provider Active NPI

Sofia Lucina Moran, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1104672930
Registry record updated Dec 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95029887 Issued in CA
Practice address
473 E. Carnegie Drive
Suite 200
San Bernardino, CA 92408
Phone
(840) 252-7774
Fax
(840) 223-5913
NPI assigned
Apr 24, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 95029887 CA Primary

Addresses

Primary practice location

473 E. Carnegie Drive
Suite 200
San Bernardino, CA 92408

Mailing address

473 E. Carnegie Drive
Suite 200
San Bernardino, CA 92408
Phone (840) 252-7774

Other names 1

  • Lucina Moran Bartlett Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606002800 CA Practitioner - Nurse Practitioner 9638611528 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians

Practice addresses (Care Compare)

18191 Von Karman Ave
Suite 100
Irvine, CA 92612-7103
Phone (619) 639-9730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95029887CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. Single Specialty CurrentSince Mar 23, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty Current Accepting new patients
Nebula Health, LLC Single Specialty CurrentSince Apr 28, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Nov 1, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm Single Specialty CurrentSince Nov 1, 2025 Accepting new patients
Nebula Health, P. C. PastSince Nov 12, 2023 Accepting new patients
Glenn Medical Center, LLC PastSince Mar 23, 2025 Accepting new patients

Locations

18191 Von Karman Ave
Ste 100
Irvine, CA 92612
Phone (530) 889-7293

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

5900 Brockton Ave
Riverside, CA 92506
Phone (800) 992-0901

6833 Indiana Ave
Ste 101
Riverside, CA 92506
Phone (657) 346-6319

806 Avenida Pico
#I330
San Clemente, CA 92673

Interoperability endpoints

  • Direct secure messaging: lbartlett5226@direct.llu.edu

Organizations & group practices 7

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": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733011200000",
    "number": "1104672930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 E. CARNEGIE DRIVE",
            "address_2": "SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "840-252-7774",
            "fax_number": "840-223-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 E. CARNEGIE DRIVE",
            "address_2": "SUITE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "840-252-7774",
            "fax_number": "840-223-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "SOFIA",
        "middle_name": "LUCINA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-12-01",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95029887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCINA",
            "last_name": "BARTLETT",
            "middle_name": "MORAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.