Karla Vanessa Moreno, PEER SUPPORT SPEC.

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

TPHNYCZUSEAWQIK Issued in CA

Practice address

142 E. Cesar Chavez Blvd.
Fresno, CA 93706-3642

Phone

(559) 600-1033

Fax

(559) 600-1101

NPI assigned

Sep 26, 2023

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fresno County

  • Preferred Provider Organization
  • Fresno, CA
  • NPI 1083936785
  NPD

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1780463984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 E. CESAR CHAVEZ BLVD.",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937063642",
            "telephone_number": "559-600-1033",
            "fax_number": "559-600-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 E. CESAR CHAVEZ BLVD.",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937063642",
            "telephone_number": "559-600-1033",
            "fax_number": "559-600-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "KARLA",
        "middle_name": "VANESSA",
        "credential": "PEER SUPPORT SPEC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "TPHNYCVZUSEAWQIK",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "TPHNYCZUSEAWQIK",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Alexandra Moreno
• Jessica Lynn Moreno, SLP-CF
• Joel Moreno
• Josefina Moreno
• Joselyn Concepcion Moreno, ASW
• Lisa M. Moreno, PA-C
• Madelynn Moreno
• Maraya Marie Moreno
• Maria Elizabeth Moreno
• Maria Grace Moreno

• Peer Specialist in Fresno, CA
• Providers in Fresno, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.