Paul Daniel Moreno Sr., SUDCC IV, BA, MA

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

900 Quebec Ave
Corcoran, CA 93212-9715

Phone

(559) 992-7100

NPI assigned

Mar 30, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crestwood Behavioral Health, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Fresno, CA
  • NPI 1093892663
  NPD (past)
• Fresno County Crestwood Fresno Bridge

  • Psychiatric Residential Treatment Facility
  • Fresno, CA
  • NPI 1558499749
  NPD (past)

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1295198992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 QUEBEC AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932129715",
            "telephone_number": "559-992-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 QUEBEC AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932129715",
            "telephone_number": "559-992-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "PAUL",
        "middle_name": "DANIEL",
        "name_suffix": "Sr.",
        "credential": "SUDCC IV, BA, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "5933",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A051500118",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "151516",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Mendoza
• Monique B Miranda, MSW, ACSW
• MMR Medical Group Inc
• Savanah Moore, PSYD
• Andrew Morelock, ACSW
• Mariam Morkos, RPH
• Jerry Alan Morris, PHARMD
• Bryan Paul Moser
• Zagros Motamed, MD
• Andrew Scott Myers, PSY.D.

• Student in an Organized Health Care Education/Training Program in Corcoran, CA
• Providers in Corcoran, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.