Individual provider Active NPI

Jessica Nicole Moniz

  • Marriage & Family Therapist
  • Concord, CA
National Provider Identifier
1710403985
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF83693 Issued in CA
Practice address
2702 Clayton Rd.
100
Concord, CA 94519-9451
Phone
(925) 222-3775
Fax
(818) 562-0914
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF83693 CA Primary

Addresses

Primary practice location

2702 Clayton Rd.
100
Concord, CA 94519-9451

Mailing address

1045 E Meadow Ave
Pinole, CA 94564-2618
Phone (510) 332-0988

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

LicenseStateTypeSpecialty
IMF83693CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1710403985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 E MEADOW AVE",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642618",
            "telephone_number": "510-332-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 CLAYTON RD.",
            "address_2": "100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945199451",
            "telephone_number": "925-222-3775",
            "fax_number": "818-562-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONIZ",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF83693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.