Active NPI
Jennifer Moreno, BA
- Community/Behavioral Health Agency
- Riverside, CA
National Provider Identifier
1447749460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Practice address
- 1650 Spruce St
Riverside, CA 92507-7402 - Phone
- (760) 634-1125
- NPI assigned
- May 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1650 Spruce St
Riverside, CA 92507-7402
Mailing address
14742 Orchid Ave
Fontana, CA 92335-4263
Phone (909) 714-8109
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
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525392000000",
"number": "1447749460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14742 ORCHID AVE",
"city": "FONTANA",
"state": "CA",
"postal_code": "923354263",
"telephone_number": "909-714-8109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 SPRUCE ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925077402",
"telephone_number": "760-634-1125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "JENNIFER",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-04",
"last_updated": "2018-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.