Individual provider Active NPI

Taylor McKelphin Moore, PSYD

  • Counselor
  • San Bernardino, CA
National Provider Identifier
1396294765
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847
Phone
(909) 501-0700
Fax
(909) 387-7611
NPI assigned
Sep 27, 2016
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Counselor 101Y00000X CA Primary

Addresses

Primary practice location

658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847

Mailing address

658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847
Phone (909) 501-0700

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Bernardino CurrentSince Jul 9, 2023 Accepting new patients

Locations

658 E Brier Dr
Ste 200
San Bernardino, CA 92408
Phone (909) 501-0700

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, 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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1396294765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082847",
            "telephone_number": "909-501-0700",
            "fax_number": "909-387-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082847",
            "telephone_number": "909-501-0700",
            "fax_number": "909-387-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELPHIN MOORE",
        "first_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.

Verify at the official NPI Registry.