Individual provider Active NPI

Yayci Moonan, PSY.D

  • Clinical Neuropsychologist
  • Jacksonville, FL
National Provider Identifier
1508574583
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY11668 Issued in FL
Practice address
4500 Salisbury Rd Ste 105
Jacksonville, FL 32216-8035
Phone
(904) 800-6116
NPI assigned
Nov 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY11668 FL Primary

Addresses

Primary practice location

4500 Salisbury Rd Ste 105
Jacksonville, FL 32216-8035

Mailing address

13512 Briarmoor CT
Orlando, FL 32837-8013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY11668FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Rehabilitation Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1508574583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13512 BRIARMOOR CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SALISBURY RD STE 105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168035",
            "telephone_number": "904-800-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONAN",
        "first_name": "YAYCI",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY11668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.