Active NPI
Kimm Moreno
- Marriage & Family Therapist
- Rancho Cucamonga, CA
National Provider Identifier
1740847730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 112514
- Practice address
- 8608 Utica Ave Ste 205
Rancho Cucamonga, CA 91730-4877 - Phone
- (951) 532-5898
- NPI assigned
- May 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 112514 | CA | Primary |
Addresses
Primary practice location
8608 Utica Ave Ste 205
Rancho Cucamonga, CA 91730-4877
Mailing address
7884 Peralta Rd
Rancho Cucamonga, CA 91730-6251
Phone (951) 532-5898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 6, 2025 through Dec 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112514 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558656000000",
"number": "1740847730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7884 PERALTA RD",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917306251",
"telephone_number": "951-532-5898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8608 UTICA AVE STE 205",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917304877",
"telephone_number": "951-532-5898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "KIMM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-24",
"last_updated": "2019-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "112514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.