Dr Moon Psychology Center Corp

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

DR MOON PSYCHOLOGY CENTER CORP

Practice address

9663 Tierra Grande St Ste 104
San Diego, CA 92126-4569

Phone

(619) 736-0333

Fax

(619) 365-5994

NPI assigned

Feb 23, 2026

Organization subpart

No

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

Authorized official

Name

Jeongmi Moon, PH.DNPI 1336566785

Title

President

Phone

(619) 736-0333

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeongmi Moon

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1336566785
  Medicare reassignment NPD Authorized official
• David Alan Boucher, PH.D.

  • Psychologist
  • San Diego, CA
  • NPI 1518966340
  NPD (past)
• Darlene Townes, PSYD

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1376985473
  NPD (past)

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1427902873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9663 TIERRA GRANDE ST STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264569",
            "telephone_number": "619-736-0333",
            "fax_number": "619-365-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9663 TIERRA GRANDE ST STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264569",
            "telephone_number": "619-736-0333",
            "fax_number": "619-365-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MOON PSYCHOLOGY CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "JEONGMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-736-0333",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.