Individual provider Active NPI

John David Moochy

  • Psychiatric/Mental Health Registered Nurse
  • Fresno, CA
National Provider Identifier
1487035762
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
95050583 Issued in CA
Practice address
258 N Blackstone Ave
Fresno, CA 93701-1913
Phone
(559) 274-0299
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95050583 CA Primary

Addresses

Primary practice location

258 N Blackstone Ave
Fresno, CA 93701-1913

Mailing address

258 N Blackstone Ave
Fresno, CA 93701-1913
Phone (559) 274-0299

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

State licenses

LicenseStateTypeSpecialty
95050583CAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1487035762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937011913",
            "telephone_number": "559-274-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 N BLACKSTONE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937011913",
            "telephone_number": "559-274-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOCHY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95050583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.