Individual provider Active NPI

Erin Lynn Moffett, CPNP

  • Pediatric Nurse Practitioner
  • Tustin, CA
National Provider Identifier
1164756151
Registry record updated Sep 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
19189 Issued in CA
Practice address
1 Hope Dr
Tustin
Tustin, CA 92782-0221
Phone
(714) 247-0306
NPI assigned
Sep 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 19189 CA Primary

Addresses

Primary practice location

1 Hope Dr
Tustin
Tustin, CA 92782-0221

Mailing address

1 Hope Dr
Tustin
Tustin, CA 92782-0221
Phone (714) 247-0306

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19189CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1164756151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "address_2": "TUSTIN",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "714-247-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "address_2": "TUSTIN",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "714-247-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "ERIN",
        "middle_name": "LYNN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "19189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.