NPIMap

Organization Active NPI

Debra Moore, PH.D.

Doing business as Fall Creek Counseling Associates

  • Psychologist
  • Roseville, CA
National Provider Identifier
1114041191
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY8578 Issued in CA
Legal business name
DEBRA MOORE, PH.D.
Doing business as
Fall Creek Counseling Associates
Practice address
775 Sunrise Ave
Suite 110
Roseville, CA 95661-4523
Phone
(916) 344-0900
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Dr. Debra Moore, PH.D.
Title
Owner
Phone
(916) 344-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X PSY8578 CA Primary

Addresses

Primary practice location

775 Sunrise Ave
Suite 110
Roseville, CA 95661-4523

Mailing address

775 Sunrise Ave
Suite 110
Roseville, CA 95661-4523
Phone (916) 344-0900

Other names 1

  • Fall Creek Counseling Associates Doing business as

National Provider Directory

National Provider Directory

Locations

5900 Coyle Ave
Ste D
Carmichael, CA 95608
Phone (916) 344-0900

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1114041191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 SUNRISE AVE",
            "address_2": "SUITE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614523",
            "telephone_number": "916-344-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 SUNRISE AVE",
            "address_2": "SUITE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614523",
            "telephone_number": "916-344-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA MOORE, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-344-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY8578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fall Creek Counseling Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.