Active NPI
James S Moran, PH.D.
- Clinical Neuropsychologist
- Pacific Grove, CA
National Provider Identifier
1528084456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY7771
- Practice address
- 621 Forest Ave
Ste 2C
Pacific Grove, CA 93950-4264 - Phone
- (831) 373-1499
- Fax
- (831) 375-1030
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 Neuropsychologist | 103G00000X | PSY7771 | CA | Primary |
Addresses
Primary practice location
621 Forest Ave
Ste 2C
Pacific Grove, CA 93950-4264
Mailing address
621 Forest Ave
Ste 2C
Pacific Grove, CA 93950-4264
Phone (831) 373-1499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY7771 | Other | CA | STATE LICENSE |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY7771 | CA | MD | Clinical Neuropsychologist |
| 7771 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528084456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 FOREST AVE",
"address_2": "STE 2C",
"city": "PACIFIC GROVE",
"state": "CA",
"postal_code": "939504264",
"telephone_number": "831-373-1499",
"fax_number": "831-375-1030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 FOREST AVE",
"address_2": "STE 2C",
"city": "PACIFIC GROVE",
"state": "CA",
"postal_code": "939504264",
"telephone_number": "831-373-1499",
"fax_number": "831-375-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "JAMES",
"middle_name": "S",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY7771",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "PSY7771",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pacific Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.