Individual provider Active NPI

Moria Collett, LMFT

  • Marriage & Family Therapist
  • Los Gatos, CA
National Provider Identifier
1124493341
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
90714 Issued in CA
Practice address
800 Pollard Rd
Suite B201
Los Gatos, CA 95032-1415
Phone
(408) 357-3736
NPI assigned
Dec 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 90714 CA Primary

Addresses

Primary practice location

800 Pollard Rd
Suite B201
Los Gatos, CA 95032-1415

Mailing address

800 Pollard Rd
Suite B201
Los Gatos, CA 95032-1415
Phone (408) 357-3736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 7, 2024 through Feb 7, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
90714CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1124493341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 POLLARD RD",
            "address_2": "SUITE B201",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321415",
            "telephone_number": "408-357-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLLARD RD",
            "address_2": "SUITE B201",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321415",
            "telephone_number": "408-357-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "MORIA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "90714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.