Active NPI
Rene Moreno, PHD
- Clinical Psychologist
- Hayward, CA
National Provider Identifier
1487848339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 27552
- Practice address
- 26081 Mocine Ave
Hayward, CA 94544-2923 - Phone
- (510) 881-5921
- Fax
- (510) 881-5925
- NPI assigned
- Sep 4, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 27552 | CA | Primary |
Addresses
Primary practice location
26081 Mocine Ave
Hayward, CA 94544-2923
Mailing address
PO Box 1068
Fremont, CA 94538-0106
Phone (510) 402-3387
Other practice location 1
41874 Higgins Way
Fremont, CA 94539-4616
Phone (510) 402-3387 ext. 120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NPI | Other | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- South County Community Health Center Inc
Practice addresses (Care Compare)
1796 Bay Rd
BLDG 2
East Palo Alto, CA 94303-1611
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27552 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1487848339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1068",
"city": "FREMONT",
"state": "CA",
"postal_code": "945380106",
"telephone_number": "510-402-3387",
"fax_number": "510-355-8315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26081 MOCINE AVE",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945442923",
"telephone_number": "510-881-5921",
"fax_number": "510-881-5925"
}
],
"practiceLocations": [
{
"address_1": "41874 Higgins Way",
"address_purpose": "LOCATION",
"city": "Fremont",
"state": "CA",
"postal_code": "945394616",
"country_code": "US",
"telephone_number": "510-402-3387 x120",
"fax_number": "510-355-8315",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORENO",
"first_name": "RENE",
"name_prefix": "Mr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-04",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "27552",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "NPI",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.