Individual provider Active NPI

Laurie Alison Moore, M.A., LMFT

  • Marriage & Family Therapist
  • Santa Cruz, CA
National Provider Identifier
1386903755
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
36950 Issued in CA
Practice address
65 Lions Field Dr
Santa Cruz, CA 95065-9736
Phone
(831) 477-7007
Fax
(832) 575-7007
NPI assigned
May 4, 2012
Last updated
May 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2012

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 36950 CA Primary

Addresses

Primary practice location

65 Lions Field Dr
Santa Cruz, CA 95065-9736

Mailing address

65 Lions Field Dr
Santa Cruz, CA 95065-9736
Phone (831) 477-7007

Other identifiers 1

IdentifierTypeStateIssuer
MFT369500OtherCABLUE SHIELD

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
36950CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1386903755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 LIONS FIELD DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950659736",
            "telephone_number": "831-477-7007",
            "fax_number": "832-575-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 LIONS FIELD DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950659736",
            "telephone_number": "831-477-7007",
            "fax_number": "832-575-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAURIE",
        "middle_name": "ALISON",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "36950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "MFT369500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.