NPIMap

Individual provider Active NPI

Jennifer L Moranda, M.D.

  • Family Medicine Physician
  • Redding, CA
National Provider Identifier
1407894702
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A88874 Issued in CA
Practice address
2410 Sonoma St
Suite 1
Redding, CA 96001-3029
Phone
(530) 243-3339
Fax
(530) 324-3582
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A88874 CA Primary

Addresses

Primary practice location

2410 Sonoma St
Suite 1
Redding, CA 96001-3029

Mailing address

2410 Sonoma St Ste 1
Redding, CA 96001-3029
Phone (530) 243-3339

Other identifiers 1

IdentifierTypeStateIssuer
00A888740MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060613000111 CA Practitioner - Family Practice 0749292704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity HealthGroup PAC ID 2062320559, 88 clinicians

Practice addresses (Care Compare)

2480 Sonoma St
Redding, CA 96001-3027
Phone (530) 576-7405

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A88874CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Current Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Galen Inpatient Physicians Inc CurrentSince Jan 1, 2014 Accepting new patients
Dignity Health CurrentSince May 11, 2015 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jan 1, 2014 Accepting new patients
James D. Tate, M.D. Past Accepting new patients
Shasta Regional Medical Center, LLC Past Accepting new patients

Locations

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2175 Rosaline Ave
Redding, CA 96001
Phone (530) 225-7247

2480 Sonoma St
Redding, CA 96001
Phone (530) 225-6090

1920 California St
Ste A
Redding, CA 96001
Phone (530) 243-3339

310 Hartnell Ave
Ste Ac
Redding, CA 96002
Phone (530) 225-6390

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1407894702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SONOMA ST STE 1",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013029",
            "telephone_number": "530-243-3339",
            "fax_number": "530-243-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SONOMA ST",
            "address_2": "SUITE 1",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013029",
            "telephone_number": "530-243-3339",
            "fax_number": "530-324-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORANDA",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A88874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A888740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.