Individual provider Active NPI

Lisa Moran, PH.D.

  • Clinical Neuropsychologist
  • Albuquerque, NM
National Provider Identifier
1386030963
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY-2024-0071 Issued in NM
Practice address
4477 Irving Blvd NW Ste B
Albuquerque, NM 87114-5529
Phone
(505) 221-6214
Fax
(505) 298-4737
NPI assigned
Apr 10, 2015
Last updated
Jan 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY-2024-0071 NM Primary
Clinical Neuropsychologist 103G00000X 26724 CA

Addresses

Primary practice location

4477 Irving Blvd NW Ste B
Albuquerque, NM 87114-5529

Mailing address

4477 Irving Blvd NW Ste B
Albuquerque, NM 87114-5529
Phone (505) 221-6214

Other practice location 1

6300 Riverside Plaza Ln NW Ste 100
Albuquerque, NM 87120-1908
Phone (505) 221-6214

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY-2024-0071NMMDClinical Neuropsychologist
26724CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Pediatric Neuropsychology, LLC Clinical Neuropsychologist Current Accepting new patients
Joanne M. Hamilton Psychologist a Professional Corporation Clinical Neuropsychologist PastSince Aug 15, 2007 Accepting new patients

Locations

4477 Irving Blvd NW
Ste B
Albuquerque, NM 87114
Phone (505) 221-6214

6300 Riverside Plaza Ln NW
Ste 100
Albuquerque, NM 87120
Phone (505) 405-3617

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1386030963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4477 IRVING BLVD NW STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145529",
            "telephone_number": "505-221-6214",
            "fax_number": "505-298-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 IRVING BLVD NW STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145529",
            "telephone_number": "505-221-6214",
            "fax_number": "505-298-4737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 Riverside Plaza Ln NW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871201908",
            "country_code": "US",
            "telephone_number": "505-221-6214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NM",
            "license": "PSY-2024-0071",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "26724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.