Individual provider Active NPI

Gustavo Robert Moreno III

  • Marriage & Family Therapist
  • Bakersfield, CA
National Provider Identifier
1447387055
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
5401 Business Park S Ste 208
Bakersfield, CA 93309-1661
Phone
(661) 889-8320
Fax
(661) 748-1910
NPI assigned
Feb 28, 2007
Last updated
Feb 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

5401 Business Park S Ste 208
Bakersfield, CA 93309-1661

Mailing address

5401 Business Park S Ste 208
Bakersfield, CA 93309-1661
Phone (661) 889-8320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909004533 CA Practitioner - Marriage and Family Therapist 2567965312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1150 E Lerdo Hwy
Suite C
Shafter, CA 93263-9420
Phone (661) 630-5890

2701 Chester Ave
Bakersfield, CA 93301-2016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51896CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Community Hospital CurrentSince Nov 5, 2025 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Delano CurrentSince Nov 5, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 1, 2025 Accepting new patients

Locations

2701 Chester Ave
Ste 101
Bakersfield, CA 93301
Phone (661) 716-9400

1401 Garces Hwy
Delano, CA 93215
Phone (661) 381-7545

Organizations & group practices 6

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1447387055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 BUSINESS PARK S STE 208",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933091661",
            "telephone_number": "661-889-8320",
            "fax_number": "661-868-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 BUSINESS PARK S STE 208",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933091661",
            "telephone_number": "661-889-8320",
            "fax_number": "661-748-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "GUSTAVO",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.