Matthew Zeno Moon

Individual provider Active NPI Marriage & Family Therapist · Hollywood, CA

NPI 1326578378 · NPPES record last updated Jun 22, 2018

Key facts

NPI
1326578378
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
Practice address
6838 W Sunset Blvd
Hollywood, CA 90028
Phone
(323) 461-3161
NPI assigned
Jun 13, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 23, 2026 through Mar 23, 2028

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X Yes

Addresses

Primary practice location

6838 W Sunset Blvd
Hollywood, CA 90028

Mailing address

6838 W Sunset Blvd
Hollywood, CA 90028-7008

Other providers in Hollywood, CA

All providers in Hollywood, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.