Active NPI
Angela Antoinette Moreno, ASW
- Clinical Social Worker
- Modesto, CA
National Provider Identifier
1649531757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ASW 30552
- Practice address
- 2215 Blue Gum Ave
Modesto, CA 95358-1052 - Phone
- (209) 525-5401
- NPI assigned
- Jun 5, 2012
- Sex
- Female
- Sole proprietor
- No
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 Social Worker | 1041C0700X | ASW 30552 | CA | Primary |
Addresses
Primary practice location
2215 Blue Gum Ave
Modesto, CA 95358-1052
Mailing address
2215 Blue Gum Ave
Modesto, CA 95358-1052
Phone (209) 525-5401
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW 30552 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1649531757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 BLUE GUM AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953581052",
"telephone_number": "209-525-5401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 BLUE GUM AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953581052",
"telephone_number": "209-525-5401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "ANGELA",
"middle_name": "ANTOINETTE",
"name_prefix": "Ms.",
"credential": "ASW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-05",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW 30552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.