Mary Elizabeth Mooradian, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY33620 Issued in CA

Practice address

4820 N 1St St Ste 103
Fresno, CA 93726-0522

Phone

(559) 840-2657

NPI assigned

Mar 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Seeds of Hope Psychological Center, PC

  • Psychologist
  • Fresno, CA
  • NPI 1760945034

  Clinical

  NPD (past)

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1154907178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 N 1ST ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260522",
            "telephone_number": "559-840-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 N 1ST ST STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260522",
            "telephone_number": "559-840-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORADIAN",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94025788",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Jeannine Moon, RN
• Rachel Moongate
• Moonlight Care Home, Inc
• Moonlight Medical Transportation Services
• Moonstone Psychological Services PC
• Aeriana Marie Moore
• Bobbie Lee Moore, LVN
• Christine Moore
• Cynthia Renee Moore
• David Scott Moore, PA-C

• Clinical Psychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.