Active NPI
Crystal Bright Moua, PHARMD
- Pharmacist
- Fresno, CA
National Provider Identifier
1194331694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 83309
- Practice address
- 4224 E Shields Ave
Fresno, CA 93726-7120 - Phone
- (559) 229-6024
- NPI assigned
- Sep 20, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 83309 | CA | Primary |
Addresses
Primary practice location
4224 E Shields Ave
Fresno, CA 93726-7120
Mailing address
722 N Clovis Ave Apt 155
Clovis, CA 93611-0364
Phone (530) 514-9256
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 Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83309 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600560000000",
"number": "1194331694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 N CLOVIS AVE APT 155",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936110364",
"telephone_number": "530-514-9256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4224 E SHIELDS AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937267120",
"telephone_number": "559-229-6024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUA",
"first_name": "CRYSTAL",
"middle_name": "BRIGHT",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-20",
"last_updated": "2020-09-20",
"certification_date": "2020-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "83309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.