Jacqueline Faith Moore

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

5450 Ralston St Ste 101
Ventura, CA 93003-6042

Phone

(805) 620-8046

NPI assigned

Jun 17, 2019

Last updated

Jun 17, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

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.

• Atiya Malik

  dba San Fernando Valley Emotional Wellness Center

  • Marriage & Family Therapist
  • Tarzana, CA
  • NPI 1487448858
  NPD (past)

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1376103838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 RALSTON ST STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035866",
            "telephone_number": "805-620-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 RALSTON ST STE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036042",
            "telephone_number": "805-620-8046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18226 Ventura Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913564246",
            "country_code": "US",
            "telephone_number": "818-758-9450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACQUELINE",
        "middle_name": "FAITH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Monzon
• Teresa M Monzon, D.D.S.
• Ashley Moody, MA, AMFT, APCC
• Laurel C Mooney
• Hannah Ellen Moore, RD
• Melanie Terras Moore, LCSW
• Kaitlyn Moorehead, PHARMD
• Irais Mora
• Ricardo Mora Jr.
• Salvador Junior Mora

• Marriage & Family Therapist in Ventura, CA
• Providers in Ventura, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.