Individual provider Active NPI

Traci Vogel Moren, L.AC.

  • Acupuncturist
  • Berkeley, CA
National Provider Identifier
1154725539
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
16248 Issued in CA
Practice address
2300 Spaulding Ave
Berkeley, CA 94703-1628
Phone
(415) 235-5092
NPI assigned
Oct 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 16248 CA Primary

Addresses

Primary practice location

2300 Spaulding Ave
Berkeley, CA 94703-1628

Mailing address

2300 Spaulding Ave
Berkeley, CA 94703-1628
Phone (415) 235-5092

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

LicenseStateTypeSpecialty
16248CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Full Moon Acupuncture CurrentSince Aug 11, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1154725539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SPAULDING AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947031628",
            "telephone_number": "415-235-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SPAULDING AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947031628",
            "telephone_number": "415-235-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREN",
        "first_name": "TRACI",
        "middle_name": "VOGEL",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.