Individual provider Active NPI

Samantha Caitlyn Moshiri, LMFT

  • Marriage & Family Therapist
  • Moorpark, CA
National Provider Identifier
1508326414
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
101985 Issued in CA
Practice address
4612 Pepper Mill St
Moorpark, CA 93021-2405
Phone
(805) 222-0030
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 101985 CA Primary

Addresses

Primary practice location

4612 Pepper Mill St
Moorpark, CA 93021-2405

Mailing address

4612 Pepper Mill St
Moorpark, CA 93021-2405
Phone (818) 983-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 2, 2024 through Jan 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
101985CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1508326414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 PEPPER MILL ST",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212405",
            "telephone_number": "818-983-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 PEPPER MILL ST",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212405",
            "telephone_number": "805-222-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHIRI",
        "first_name": "SAMANTHA",
        "middle_name": "CAITLYN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "101985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

Verify at the official NPI Registry.