Active NPI
Larry Samuel Moricca, PH.D.
- Clinical Psychologist
- Clovis, CA
National Provider Identifier
1851441810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY7595
- Practice address
- 642 Pollasky Ave
#210
Clovis, CA 93612-1875 - Phone
- (559) 999-0143
- Fax
- (559) 412-2104
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY7595 | CA | Primary |
Addresses
Primary practice location
642 Pollasky Ave
#210
Clovis, CA 93612-1875
Mailing address
12588 Cades Bay Cir
Bradenton, FL 34211-1604
Phone (559) 999-0143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120222000137 | CA | Practitioner - Clinical Psychologist | 5092973065 | Practice locations: Clovis, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
642 Pollasky Ave
Suite 210
Clovis, CA 93612-1875
Phone (559) 999-0143
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY7595 | CA | MD | Clinical Psychologist |
| 7595 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1851441810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12588 CADES BAY CIR",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342111604",
"telephone_number": "559-999-0143",
"fax_number": "559-412-2104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "642 POLLASKY AVE",
"address_2": "#210",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936121875",
"telephone_number": "559-999-0143",
"fax_number": "559-412-2104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORICCA",
"first_name": "LARRY",
"middle_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY7595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.