Carmell J Moore

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3620 W Hammer LN
Stockton, CA 95219-5435

Phone

(209) 521-4791

NPI assigned

May 17, 2021

Last updated

May 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Kadiant, LLC

  • Behavior Analyst
  • Oakland, CA
  • NPI 1811547052
  NPD (past)

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1316511025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10132 RIVER PARK CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094182",
            "telephone_number": "209-986-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952195435",
            "telephone_number": "209-521-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CARMELL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jae Yong Moon, PHARM D.
• Yoe M Moon, PSY.D, MA
• Shameka Shantell Moore-Akingbemila
• Ashley Lynn Moore
• Brandy S Moore
• Chermayne Chantel Moore
• Courtney Moore, BCBA, LBA
• Diamond Elizabeth Jordana Moore
• Kiyle Dillion Moore
• Maya Moore

• Behavior Technician in Stockton, CA
• Providers in Stockton, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.