Masood Moghaddam, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW91689 Issued in CA

Practice address

5975 Entrada Ave Unit 122
Atascadero, CA 93422-4223

Phone

(415) 902-1296

Fax

(805) 466-9765

NPI assigned

Dec 30, 2015

Sex

Male

Sole proprietor

Yes

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

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: masoodmoghaddam@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD
• SH Squared Cares

  • Clinical Psychologist
  • Templeton, CA
  • NPI 1245720960
  NPD (past)

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1710342126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9435 JORNADA LN APT 6",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225874",
            "telephone_number": "415-902-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5975 ENTRADA AVE UNIT 122",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224223",
            "telephone_number": "415-902-1296",
            "fax_number": "805-466-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADDAM",
        "first_name": "MASOOD",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-30",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW91689",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "126862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Brandon Mireles
• Cindy Mitchell, PHD
• Sean Ingram Mitchell
• Vivian Mitchell, APCC
• Morgan Miyoshi
• Marie Stephanie Mohapp, LCSW
• Molly Anne Eisen-Kearns, Licensed Clinical Social Worker Inc.
• Monarch Behavior Solutions, Inc.
• Kastina Rae Moore
• Jazmin Melody Mora

• Clinical Social Worker in Atascadero, CA
• Providers in Atascadero, 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 Mar 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.