Individual provider Active NPI

Moses Pacheco III

  • Marriage & Family Therapist
  • Stockton, CA
National Provider Identifier
1366845232
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
127871 Issued in CA
Practice address
1305 Tommydon St
Stockton, CA 95210-3364
Phone
(209) 476-5143
NPI assigned
Oct 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 123462 CA
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 127871 CA Primary

Addresses

Primary practice location

1305 Tommydon St
Stockton, CA 95210-3364

Mailing address

7373 West LN
Stockton, CA 95210-3377
Phone (209) 476-5143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240529000569 CA Practitioner - Marriage and Family Therapist 9234571845 Reassigns benefits to 1 organization
I20250428001666 CA Practitioner - Marriage and Family Therapist 9234571845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1305 Tommydon St
Stockton, CA 95210-3364
Phone (209) 476-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127871CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Jun 21, 2025 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jun 21, 2025 Accepting new patients
Center for New Directions, Inc. CurrentSince Mar 30, 2024 Accepting new patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc PastSince Dec 25, 2018 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

1305 Tommydon St
Stockton, CA 95210
Phone (209) 476-2015

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1366845232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 WEST LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103377",
            "telephone_number": "209-476-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 TOMMYDON ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952103364",
            "telephone_number": "209-476-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "MOSES",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-06",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "123462",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.