Active NPI
Melody Moore, PH.D.
- Clinical Psychologist
- Manhattan Beach, CA
National Provider Identifier
1659981256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31065
- Practice address
- 417 33Rd St
Manhattan Beach, CA 90266-3814 - Phone
- (214) 912-8693
- NPI assigned
- Aug 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 31065 | CA | Primary |
| Clinical Psychologist | 103TC0700X | 33208 | TX |
Addresses
Primary practice location
417 33Rd St
Manhattan Beach, CA 90266-3814
Mailing address
417 33Rd St
Manhattan Beach, CA 90266-3814
Phone (214) 912-8693
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31065 | CA | MD | Mental Health Counselor |
| 33208 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596758400000",
"number": "1659981256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 33RD ST",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "902663814",
"telephone_number": "214-912-8693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 33RD ST",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "902663814",
"telephone_number": "214-912-8693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MELODY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-07",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "31065",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "33208",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.