Individual provider Active NPI

Carey Christine Mooney, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Simi Valley, CA
National Provider Identifier
1376784785
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16763 Issued in CA
Practice address
2665 Park Center Dr Ste D
Simi Valley, CA 93065-6200
Phone
(805) 416-3384
NPI assigned
Mar 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16763 CA Primary

Addresses

Primary practice location

2665 Park Center Dr Ste D
Simi Valley, CA 93065-6200

Mailing address

2665 Park Center Dr Ste D
Simi Valley, CA 93065-6200
Phone (808) 416-3384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16763CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Connection Developmental Therapy Center CurrentSince Jan 26, 2022 Accepting new patients

Locations

2665 Park Center Dr
Ste D
Simi Valley, CA 93065
Phone (805) 416-3384

Organizations & group practices 1

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": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1376784785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 PARK CENTER DR STE D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656200",
            "telephone_number": "808-416-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 PARK CENTER DR STE D",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656200",
            "telephone_number": "805-416-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "CAREY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-13",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "16763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.