Individual provider Active NPI

Chermayne Chantel Moore

  • Marriage & Family Therapist
  • Stockton, CA
National Provider Identifier
1700396850
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
152655 Issued in CA
Practice address
1803 W March LN
Stockton, CA 95207-6458
Phone
(209) 636-5353
NPI assigned
Oct 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 124414 CA
Marriage & Family Therapist 106H00000X 152655 CA Primary
Counselor 101Y00000X

Addresses

Primary practice location

1803 W March LN
Stockton, CA 95207-6458

Mailing address

1803 W March LN Ste C
Stockton, CA 95207-6414

Other practice location 1

7236 S Recovery Rd
French Camp, CA 95231-8901
Phone (209) 888-6595 ext. 6

Other practice location 2

7224 S Recovery Rd
French Camp, CA 95231-8901
Phone (209) 888-6595 ext. 5

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250425000193 CA Practitioner - Marriage and Family Therapist 8820514524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124414CAMDMental Health Counselor
152655CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Joaquin CurrentSince Feb 16, 2025 Accepting new patients
San Joaquin Behavioral Health Services Mental Health CurrentSince Feb 16, 2025 Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1700396850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W MARCH LN STE C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076458",
            "telephone_number": "209-636-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7236 S Recovery Rd",
            "address_purpose": "LOCATION",
            "city": "French Camp",
            "state": "CA",
            "postal_code": "952318901",
            "country_code": "US",
            "telephone_number": "209-888-6595 x6",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7224 S Recovery Rd",
            "address_purpose": "LOCATION",
            "city": "French Camp",
            "state": "CA",
            "postal_code": "952318901",
            "country_code": "US",
            "telephone_number": "209-888-6595 x5",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHERMAYNE",
        "middle_name": "CHANTEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "124414",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152655",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.