Organization Active NPI

James V Moore PH D Psychologist Inc

  • Clinical Psychologist
  • Walnut Creek, CA
National Provider Identifier
1225341084
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4917 Issued in CA
Legal business name
JAMES V MOORE PH D PSYCHOLOGIST INC
Practice address
1844 San Miguel Dr
Suite #300a
Walnut Creek, CA 94596-4962
Phone
(925) 935-4448
Fax
(925) 935-5135
NPI assigned
Jul 22, 2010
Last updated
Aug 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Authorized official

Name
Dr. James Vernon Moore, PH.D.NPI 1225138282
Title
President/Psychotherapist
Phone
(925) 935-4448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY4917 CA Primary

Addresses

Primary practice location

1844 San Miguel Dr
Suite #300a
Walnut Creek, CA 94596-4962

Mailing address

1844 San Miguel Dr
Suite #300a
Walnut Creek, CA 94596-4962
Phone (925) 935-4448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100810001159 CA Part B Supplier - Clinic/Group Practice 9537293709 Receives reassigned benefits from 1 practitioner
Practice locations: Walnut Creek, CA

National Provider Directory

National Provider Directory

Locations

1844 San Miguel Dr
Ste 300A
Walnut Creek, CA 94596
Phone (925) 935-4448

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1225341084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 SAN MIGUEL DR",
            "address_2": "SUITE #300A",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964962",
            "telephone_number": "925-935-4448",
            "fax_number": "925-935-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 SAN MIGUEL DR",
            "address_2": "SUITE #300A",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964962",
            "telephone_number": "925-935-4448",
            "fax_number": "925-935-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES V MOORE PH D PSYCHOLOGIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "PRESIDENT/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "925-935-4448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.