Nina A Moreno, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

84536 Issued in CA

Practice address

1682 Novato Blvd Ste 105
Novato, CA 94947

Phone

(415) 473-7812

NPI assigned

Sep 19, 2013

Last updated

Oct 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1619303906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 COWBARN LN APT 13",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949475142",
            "telephone_number": "415-761-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1682 NOVATO BLVD STE 105",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94947",
            "telephone_number": "415-473-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "NINA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "84536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619303906",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monarch Chiropractic
• Monroe Operations, LLC (Newport Academy-Rush Creek)
• Mollie Moore, PA-C, MSPAS, MPH
• Monica Anne Moore, MFT
• Michelle Morales
• Dennis Shigeru Moribe, MD
• Nakuia Morris
• Susan Mozayani, O.D
• Ritu Mukerji-Metzger, MD
• Laura Mullen, MD

• Clinical Social Worker in Novato, CA
• Providers in Novato, 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 Oct 23, 2020; 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.