Latasha Christine Moon, CRANIAL PROSTHESIS

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1267 Willis St # 200
Redding, CA 96001-0400

Phone

(916) 365-2013

NPI assigned

Jan 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1710577168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 PARTINGTON CIR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957576282",
            "telephone_number": "216-798-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 WILLIS ST # 200",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010400",
            "telephone_number": "916-365-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "LATASHA",
        "middle_name": "CHRISTINE",
        "credential": "CRANIAL PROSTHESIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leanna Montgomery
• Myranda Montgomery
• Richard Montgomery, R.N., F.N.P.
• Sydney Lee Montgomery, NP
• Socorro Montoya
• Wendy J Moon, M.A.
• Julia E Mooney, MD
• Amanda Mooneyham, MD
• Michael Joel Moore, D.C.
• Schimar Racine Mora

• Specialist in Redding, CA
• Providers in Redding, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.