Individual provider Active NPI

Cynthia Gabrielle Moquin, RN, CNS

  • Psychiatric/Mental Health Registered Nurse
  • Newport, OR
National Provider Identifier
1164460259
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
201401150RN Issued in OR
Practice address
51 SW Lee St
Newport, OR 97365-3823
Phone
(541) 574-5960
Fax
(541) 265-0601
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X RN 436250 CA
Mental Health Counselor 101YM0800X CNS 1914 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X 201401150RN OR Primary

Addresses

Primary practice location

51 SW Lee St
Newport, OR 97365-3823

Mailing address

36 SW Nye St
Newport, OR 97365-3821
Phone (541) 574-5960

Other practice location 1

5105 Walker St
Ventura, CA 93003-7358
Phone (805) 886-5737

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)
Enrolled
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
CNS 1914CAMDMental Health Counselor
RN 436250CAMDMental Health Counselor
201401150RNORMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164460259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SW NYE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653821",
            "telephone_number": "541-574-5960",
            "fax_number": "541-265-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SW LEE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653823",
            "telephone_number": "541-574-5960",
            "fax_number": "541-265-0601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5105 Walker St",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930037358",
            "country_code": "US",
            "telephone_number": "805-886-5737",
            "fax_number": "805-681-4548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOQUIN",
        "first_name": "CYNTHIA",
        "middle_name": "GABRIELLE",
        "credential": "RN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "RN 436250",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "CNS  1914",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201401150RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.