Active NPI
Doris Louise Moore, PHD, MSW, RAS
- Clinical Social Worker
- Martinez, CA
National Provider Identifier
1184762486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 29143
- Practice address
- 25 Allen Street
Martinez, CA 94553-1513 - Phone
- (925) 313-7900
- NPI assigned
- Feb 1, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 29143 | CA | Primary |
Addresses
Primary practice location
25 Allen Street
Martinez, CA 94553-1513
Mailing address
2951 Derby Street
#214
Berkeley, CA 94705-1973
Phone (510) 529-4506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184762486 | Medicaid | CA |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29143 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1184762486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2951 DERBY STREET",
"address_2": "#214",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051973",
"telephone_number": "510-529-4506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 ALLEN STREET",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945531513",
"telephone_number": "925-313-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DORIS",
"middle_name": "LOUISE",
"credential": "PHD, MSW, RAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "29143",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1184762486",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.