Active NPI
Skyler Whitney Moore
- Behavior Analyst
- San Bernardino, CA
National Provider Identifier
1114201373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 225XM0800X
- Practice address
- 572 N Arrowhead Ave Ste 200
San Bernardino, CA 92401-1212 - Phone
- (909) 800-8345
- NPI assigned
- Oct 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 225XM0800X | CA | Primary |
Addresses
Primary practice location
572 N Arrowhead Ave Ste 200
San Bernardino, CA 92401-1212
Mailing address
572 N Arrowhead Ave Ste 200
San Bernardino, CA 92401-1212
Phone (909) 800-8345
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225XM0800X | CA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426118400000",
"number": "1114201373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "572 N ARROWHEAD AVE STE 200",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924011212",
"telephone_number": "909-800-8345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "572 N ARROWHEAD AVE STE 200",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924011212",
"telephone_number": "909-800-8345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SKYLER",
"middle_name": "WHITNEY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-06",
"last_updated": "2015-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "225XM0800X",
"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 Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.