Michelle Joceline Moore, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY19780 Issued in CA

Practice address

647 Camino de Los Mares Ste 223a
San Clemente, CA 92673-2807

Phone

(949) 933-1570

NPI assigned

Jun 20, 2022

Last updated

Jun 20, 2022By the provider in NPPES

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

Enrolled in CA

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michelle Moore PHD Inc. a Professional Psychological Corpora

  • Psychologist
  • Carlsbad, CA
  • NPI 1104795731
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1790416824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 CAMINO DE LOS MARES STE 223A",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732807",
            "telephone_number": "949-933-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 CAMINO DE LOS MARES STE 223A",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732807",
            "telephone_number": "949-933-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHELLE",
        "middle_name": "JOCELINE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie E Montgomery, MA, CCC-SLP
• Jerica Montgomery
• Gennifer M Montoya, Z58464
• Ashton Elizabeth Moore
• Don Moore, DC
• Kelly Rose Mora
• Alice P Moran, DMD
• Efraim John Moreno I, DMD
• Chrissie Morgan, P.T.
• Bijan Bagher Moridani, M.D.

• Psychologist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.