Kathryn Theresa Moffa, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

34626 Issued in CA

Practice address

Choc Children'S Specialists 1201 W. la Veta Ave.
Orange, CA 92868-4203

Phone

(888) 770-2462

NPI assigned

Sep 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1295340388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHOC CHILDREN'S SPECIALISTS 1201 W. LA VETA AVE.",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "888-770-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHOC CHILDREN'S SPECIALISTS 1201 W. LA VETA AVE.",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "888-770-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFA",
        "first_name": "KATHRYN",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2023-10-30",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "11412",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "34626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Modir, PHD
• Alexa Modrell, MD
• Behram Parvez Mody, MD
• John Moeller, M.D.
• Makenna Ryan Moeller
• Julie Reeker Moghal, PH.D.
• Caroline Moh, M.S.N.
• Asma Mohamedelhassan Ahme Mohamedkhair
• Ali Mohammadzadeh Kouhpareh
• Luqman Yakoub Mohammed

• Clinical Child & Adolescent Psychologist in Orange, CA
• Providers in Orange, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.