Theraq, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

THERAQ, INC

Practice address

17752 Sky Park Circle
Suite 245
Irvine, CA 92614

Phone

(714) 922-0720

NPI assigned

Oct 25, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Katherine Moore, PSYDNPI 1861946873

Title

Officer of the Board of Directors

Phone

(714) 922-0720

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Moore, PSYD

  • Clinical Psychologist
  • Irvine, CA
  • NPI 1861946873
  NPD Authorized official

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1285456905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20409 YORBA LINDA BLVD STE 237",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863042",
            "telephone_number": "714-922-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17752 SKY PARK CIRCLE",
            "address_2": "SUITE 245",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92614",
            "telephone_number": "714-922-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAQ, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OFFICER OF THE BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "714-922-0720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Irvine, CA
• Providers in Irvine, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.