Active NPI
Paisley Demetria Moore
- Rehabilitation Practitioner
- La Verne, CA
National Provider Identifier
1184188385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1350 3Rd St
La Verne, CA 91750-5201 - Phone
- (909) 593-2581
- NPI assigned
- Jan 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1350 3Rd St
La Verne, CA 91750-5201
Mailing address
PO Box 400
La Verne, CA 91750-0400
Phone (909) 593-2581
Other practice location 1
155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone (213) 381-2931 ext. 150
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691366400000",
"number": "1184188385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 400",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917500400",
"telephone_number": "909-593-2581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 3RD ST",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917505201",
"telephone_number": "909-593-2581"
}
],
"practiceLocations": [
{
"address_1": "155 N Occidental Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900264641",
"country_code": "US",
"telephone_number": "213-381-2931 x150",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "PAISLEY",
"middle_name": "DEMETRIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-22",
"last_updated": "2023-08-07",
"certification_date": "2023-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Verne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.