Deidrae Moffett, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

84494 Issued in CA

Practice address

21 Tamal Vista Blvd
194
Corte Madera, CA 94925-1130

Phone

(415) 377-7308

NPI assigned

Jan 21, 2016

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1760849723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD",
            "address_2": "194",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD",
            "address_2": "194",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251130",
            "telephone_number": "415-377-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "DEIDRAE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "84494",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "84494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan G Millstein, PH.D.
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• Heidi Klein Minnick, PH.D.
• Rochelle Byrd Mishkin, LMFT #119416
• Jia Mizell
• Lisa Monardi, AU.D.
• Bruce Duncan Moore, D.C
• Molly Moreira, DC
• Karen Morelli, LMFT
• Marcie Morton, DC

• Marriage & Family Therapist in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.