Individual provider Active NPI

Louise Moore, MFT

  • Marriage & Family Therapist
  • Petaluma, CA
National Provider Identifier
1366874638
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
50623 Issued in CA
Practice address
222 Weller St Ste 202
Petaluma, CA 94952-7107
Phone
(707) 774-1225
NPI assigned
Aug 8, 2013
Reactivated
Aug 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 50623 CA Primary

Addresses

Primary practice location

222 Weller St Ste 202
Petaluma, CA 94952-7107

Mailing address

434 Decanter Cir
Windsor, CA 95492-6663
Phone (707) 774-1225

Other names 1

  • Louise Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260611003478 CA Practitioner - Marriage and Family Therapist 8729508692 Practice locations: Petaluma, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 Weller St
Suite 202
Petaluma, CA 94952-7107
Phone (707) 774-1225

434 Decanter Cir
Windsor, CA 95492-6663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50623CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Louise Moore CurrentSince Sep 27, 2020 Accepting new patients
Psych Strategies Inc a Psychological Corp PastSince Aug 1, 2002 Accepting new patients

Locations

7 4th St
Ste 13
Petaluma, CA 94952
Phone (707) 330-5321

Organizations & group practices 2

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": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1366874638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 DECANTER CIR",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954926663",
            "telephone_number": "707-774-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 WELLER ST STE 202",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949527107",
            "telephone_number": "707-774-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LOUISE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "deactivation_date": "2020-08-12",
        "reactivation_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "50623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOUISE",
            "last_name": "MOORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.