Courtney Diane Moore, RADT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

835 25TH St
San Diego, CA 92102-2738

Phone

(619) 239-9691

NPI assigned

Apr 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Crash, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1124539960
  NPD (past)

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1134749757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120165",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92112",
            "telephone_number": "619-929-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 25TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022738",
            "telephone_number": "619-239-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "COURTNEY",
        "middle_name": "DIANE",
        "credential": "RADT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Moore
• Cinta Latrece Moore
• Colleen Moore, AU.D.
• Courtney Moore
• Courtney Danielle Moore, LCSW
• Darryl Kenneth Moore, PHD
• Donald Joe Moore, M.D.
• Eileen Moore
• Fiona Moore
• Gene P Moore, DDS

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.