Individual provider Active NPI

Rachel Trevino Moreno

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1821390022
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
110221 Issued in CA
Practice address
2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Phone
(559) 443-4800
NPI assigned
Nov 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 110221 CA Primary

Addresses

Primary practice location

2560 W Shaw LN Ste 104
Fresno, CA 93711-2777

Mailing address

2560 W Shaw LN Ste 104
Fresno, CA 93711-2777
Phone (559) 443-4800

Other practice location 1

4939 E Yale Ave
Fresno, CA 93727-1523
Phone (559) 443-4800

Other practice location 2

2020 High St
Selma, CA 93662-3518
Phone (559) 443-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
110221CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno County Superintendent of Schools CurrentSince Feb 11, 2024 Accepting new patients
Fresno County Superintendent of Schools CurrentSince Apr 1, 2024 Accepting new patients
Fresno Pacific University Dba Pacific Counseling Center Marriage & Family Therapist PastSince Jun 1, 2022 Accepting new patients

Locations

2440 Tulare St
Ste 200
Fresno, CA 93721
Phone (559) 265-3089

4939 E Yale Ave
Fresno, CA 93727
Phone (559) 443-4820

2560 W Shaw Ln
Ste 104
Fresno, CA 93711
Phone (559) 431-1086

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1821390022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4939 E Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271523",
            "country_code": "US",
            "telephone_number": "559-443-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 High St",
            "address_purpose": "LOCATION",
            "city": "Selma",
            "state": "CA",
            "postal_code": "936623518",
            "country_code": "US",
            "telephone_number": "559-443-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "RACHEL",
        "middle_name": "TREVINO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-22",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.