Active NPI
Dawn M Moore
- Marriage & Family Therapist
- Escondido, CA
National Provider Identifier
1396008330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 136684
- Practice address
- 235 W 5TH Ave Ste 130
Escondido, CA 92025-4877 - Phone
- (619) 740-1721
- Fax
- (760) 466-1558
- NPI assigned
- Jun 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 107563 | CA | |
| Rehabilitation Practitioner | 225400000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 136684 | CA | Primary |
Addresses
Primary practice location
235 W 5TH Ave Ste 130
Escondido, CA 92025-4877
Mailing address
235 W 5TH Ave Ste 130
Escondido, CA 92025-4877
Phone (619) 740-1721
Other practice location 1
8775 Aero Dr Ste 132
San Diego, CA 92123-1779
Phone (858) 609-8742
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107563 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1396008330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 W 5TH AVE STE 130",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920254877",
"telephone_number": "619-740-1721",
"fax_number": "760-466-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 W 5TH AVE STE 130",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920254877",
"telephone_number": "619-740-1721",
"fax_number": "760-466-1558"
}
],
"practiceLocations": [
{
"address_1": "8775 Aero Dr Ste 132",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921231779",
"country_code": "US",
"telephone_number": "858-609-8742",
"fax_number": "858-292-0322",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "DAWN",
"middle_name": "M",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-22",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "107563",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "136684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.