Joseph Kelly Moreno, PH.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY 13000 Issued in CA

Practice address

6642 Bellevue Orchard LN
San Luis Obispo, CA 93405-8067

Phone

(805) 756-2805

Fax

(805) 756-1134

NPI assigned

Feb 22, 2011

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1578860938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6642 BELLEVUE ORCHARD LN",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934058067",
            "telephone_number": "805-756-2805",
            "fax_number": "805-756-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6642 BELLEVUE ORCHARD LN",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934058067",
            "telephone_number": "805-756-2805",
            "fax_number": "805-756-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "JOSEPH",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY 13000",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "UT",
            "license": "4940521-2501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yesenia Hernandez Mora
• Jonas Morales, NP
• Daniel Robert More, M.D.
• Amanda Moreno, PSY.D.
• Cassidy Emi Adams Moreno, M.A., BCBA
• Lisa Kathleen Moreno, OTR/L, CHT, PAMS
• Samuel Joseph Moreno
• Sandra Ann Moreno
• Scott Anthony Morey Jr., M.D.
• Ixchel Morfin

• Forensic Psychologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.