Julian Moonlightt

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

1639965189 Issued in CA

Practice address

111 Modesto Ave
Modesto, CA 95354-0414

Phone

(209) 408-8848

NPI assigned

Jan 16, 2026

Sex

Unspecified or another gender identity

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

State licenses

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

{
    "created_epoch": "1768521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1497614358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 H ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542443",
            "telephone_number": "209-681-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MODESTO AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953540414",
            "telephone_number": "209-408-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONLIGHTT",
        "first_name": "JULIAN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-01-16",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": "1639965189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Moody
• Robert Patrick Moody, PH.D.
• Rustin Moon
• Jenny L Mooney, PA-C
• Kelsey Lynn Mooney, DPT
• Desiree Moore
• Etelka Moore
• Holly Elizabeth Moore
• Rylee Moore
• Sandra Centeno Moore, LCSW

• Community Health Worker in Modesto, CA
• Providers in Modesto, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; 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.