Individual provider Active NPI

Anthony Moore, LMFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1871041855
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
121972 Issued in CA
Practice address
5706 Cahalan Ave # 23075
San Jose, CA 95123-3008
Phone
(408) 375-7469
NPI assigned
Sep 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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 121972 CA Primary

Addresses

Primary practice location

5706 Cahalan Ave # 23075
San Jose, CA 95123-3008

Mailing address

5706 Cahalan Ave # 23075
San Jose, CA 95123-3008
Phone (408) 375-7469

Other practice location 1

151 W Mission St
San Jose, CA 95110-1713
Phone (408) 345-1715

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410002197 CA Practitioner - Marriage and Family Therapist 4082052998 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Mar 8, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1871041855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 CAHALAN AVE # 23075",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233008",
            "telephone_number": "408-375-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5706 CAHALAN AVE # 23075",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233008",
            "telephone_number": "408-375-7469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 W Mission St",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951101713",
            "country_code": "US",
            "telephone_number": "408-345-1715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-19",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.