Active NPI
Samuel Allen Moehlenpah, MA, MFT
- Marriage & Family Therapist
- Poway, CA
National Provider Identifier
1205920907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC37887
- Practice address
- 12975 Brookprinter PL
Suite 140
Poway, CA 92064-8894 - Phone
- (619) 253-5315
- Fax
- (858) 486-0108
- NPI assigned
- Oct 3, 2006
- Last updated
- Mar 6, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC37887 | CA | Primary |
Addresses
Primary practice location
12975 Brookprinter PL
Suite 140
Poway, CA 92064-8894
Mailing address
12975 Brookprinter PL
Suite 140
Poway, CA 92064-8894
Phone (619) 253-5315
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC37887 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive at Home | Marriage & Family Therapist | Current | Accepting new patients |
Locations
12975 Brookprinter Pl
Ste 140
Poway, CA 92064
Phone (619) 253-5315
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425600000000",
"number": "1205920907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12975 BROOKPRINTER PL",
"address_2": "SUITE 140",
"city": "POWAY",
"state": "CA",
"postal_code": "920648894",
"telephone_number": "619-253-5315",
"fax_number": "858-486-0108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12975 BROOKPRINTER PL",
"address_2": "SUITE 140",
"city": "POWAY",
"state": "CA",
"postal_code": "920648894",
"telephone_number": "619-253-5315",
"fax_number": "858-486-0108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOEHLENPAH",
"first_name": "SAMUEL",
"middle_name": "ALLEN",
"credential": "MA, MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2015-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC37887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.