Lisa Kathleen Moore, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT2345 Issued in CA

Practice address

9116 Foothill Blvd Ste 102
Rancho Cucamonga, CA 91730-6564

Phone

(909) 941-7177

Fax

(909) 941-1717

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cofordo, Inc.

  • Physical Therapist
  • Rancho Cucamonga, CA
  • NPI 1942236351
  NPD (past) Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417976754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11206 ROSARITA DR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543210",
            "telephone_number": "909-435-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9116 FOOTHILL BLVD STE 102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306564",
            "telephone_number": "909-941-7177",
            "fax_number": "909-941-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LISA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT2345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanna Sol Moon, MSOT, OTR/L
• Andrea G Moore-Emmett, LMFT
• Annemae Moore
• Gwendolyn Moore, MPH, RD
• Isiah Moore
• Alexander Moqattash, DDS
• Stephanie Mora-Rodriguez
• Faith Mora
• Melissa Mora, MS, BCBA
• Ailin Morales Jimenez

• Physical Therapy Assistant in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.