Kevin Patrick Moody

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT118244 Issued in CA

Practice address

46 N 2ND St
Campbell, CA 95008

Phone

(408) 345-5572

NPI assigned

Aug 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Family Tree Wellness, Inc

  • Mental Health Counselor
  • Campbell, CA
  • NPI 1467091793
  NPD

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

{
    "created_epoch": "1502496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653696000000",
    "number": "1124543970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 N 2ND ST",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082026",
            "telephone_number": "408-827-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 N 2ND ST",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-345-5572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 Llewellyn Ave",
            "address_purpose": "LOCATION",
            "city": "Campbell",
            "state": "CA",
            "postal_code": "95008",
            "country_code": "US",
            "telephone_number": "408-761-2286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "499 Loma Alta Ave",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950306227",
            "country_code": "US",
            "telephone_number": "408-515-9577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-12",
        "last_updated": "2022-05-28",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT118244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Michael Monahan, MD
• Alen Naig Mondido
• Gabriela Montenegro
• Christelle Camila Montes Barraza
• Aaliyah Ariel Montgomery
• Sung Bum Moon, L.AC
• Sean Moore
• Peter Allan Moosman, DDS
• Rodolfo Antonio Morales, MD
• Estrella Moran Meza

• Marriage & Family Therapist in Campbell, CA
• Providers in Campbell, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2022; 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.