John Moore III, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

29285 Issued in CA

Practice address

1000 Broadway Ste 460
Oakland, CA 94607-4033

Phone

(510) 506-1719

Fax

(510) 465-5520

NPI assigned

Dec 17, 2018

Last updated

Dec 17, 2018By the provider in NPPES

Sex

Male

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

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1487125480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BROADWAY STE 460",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074033",
            "telephone_number": "510-506-1719",
            "fax_number": "510-465-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BROADWAY STE 460",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074033",
            "telephone_number": "510-506-1719",
            "fax_number": "510-465-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "29285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Moore
• Engret Moore
• Gaea S. Moore, MD
• Glenda Irene Moore, FNP
• Howard Moore III
• Joshua Moore, DC
• Justin Earl Moore, MD
• Keelah Moore
• Keith Bronson Moore Jr., LVN
• Kristine Marie Moore, MFTI

• Clinical Child & Adolescent Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.

Verify at the official NPI Registry.