Moana Lynn Easterly

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

Practice address

4101 Harris Ave
Las Vegas, NV 89110-2252

Phone

(702) 954-0052

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1790484061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 HARRIS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891102252",
            "telephone_number": "702-954-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 HARRIS AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891102252",
            "telephone_number": "702-954-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLY",
        "first_name": "MOANA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Rehabilitation Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.