Sammantha Vionnie Moreno, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

107152 Issued in CA

Practice address

301 E 13TH St Ste D
Merced, CA 95341-6211

Phone

(209) 381-6800

NPI assigned

Sep 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thrive Psychological Services Inc

  dba Thrive Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ontario, CA
  • NPI 1528640026
  Medicare reassignment NPD

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1508416942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W MAIN ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953404928",
            "telephone_number": "209-628-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 13TH ST STE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416211",
            "telephone_number": "209-381-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "SAMMANTHA",
        "middle_name": "VIONNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91812",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "107152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Moreno
• Jazmin Moreno
• Madelyn Moreno
• Miranda Jesselle Moreno
• Necia Elene Moreno
• Stasha Jennifer Moreno
• Denise Morris
• Ada Morrow, PSY.D.
• Brittany Ann Moseli, APCC/AMFT
• Jade Mosely

• Clinical Social Worker in Merced, CA
• Providers in Merced, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.