Thomas Ian Moore

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW70618 Issued in CA

Practice address

3132 Jefferson St
San Diego, CA 92110-4421

Phone

(619) 683-3100

NPI assigned

Mar 18, 2016

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1679934608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 JEFFERSON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104421",
            "telephone_number": "619-683-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 JEFFERSON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104421",
            "telephone_number": "619-683-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "THOMAS",
        "middle_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW70618",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Yvette Moore, MD, MPH
• Shavon Cherelle Moore, MD
• Tahelmisha Moore
• Tammy Moore, CMT
• Tatiana M. Moore, MFT
• Victoria Moore, PSY.D
• Wendi Lynn Moore, LCSW
• Wendy Heather Moore, O.T.
• Zeninah Moore
• Katelyn Moorman, IDC

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; 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.