Individual provider Active NPI

Caroline Barrie Moore

  • Marriage & Family Therapist
  • Sebastopol, CA
National Provider Identifier
1720962103
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT156623 Issued in CA
Practice address
536 S Main St
Sebastopol, CA 95472-4261
Phone
(650) 817-5335
NPI assigned
Jul 31, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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 AMFT156623 CA Primary

Addresses

Primary practice location

536 S Main St
Sebastopol, CA 95472-4261

Mailing address

536 S Main St
Sebastopol, CA 95472-4261
Phone (650) 817-5335

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
AMFT156623CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1753920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1720962103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 S MAIN ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724261",
            "telephone_number": "650-817-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 S MAIN ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724261",
            "telephone_number": "650-817-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CAROLINE",
        "middle_name": "BARRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT156623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.