Individual provider Active NPI

Michael Lemuel Moore Sr., B.A., M.S.

  • Pastoral Counselor
  • Brentwood, CA
National Provider Identifier
1194519207
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
Practice address
665 Rotunda Way
Brentwood, CA 94513-5534
Phone
(925) 450-8182
NPI assigned
Apr 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X
Pastoral Counselor 101YP1600X CA Primary

Addresses

Primary practice location

665 Rotunda Way
Brentwood, CA 94513-5534

Mailing address

665 Rotunda Way
Brentwood, CA 94513-5534

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
Bachelor of Arts, Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1194519207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 ROTUNDA WAY",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 ROTUNDA WAY",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135534",
            "telephone_number": "925-450-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "LEMUEL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "B.A., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2025; 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.