Active NPI
Serena Souksakhone Moua
- Marriage & Family Therapist
- Santa Clara, CA
National Provider Identifier
1922528116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 156502
- Practice address
- 5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140 - Phone
- (323) 205-7088
- Fax
- (833) 419-0181
- NPI assigned
- Jun 20, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1324030918 | CA | |
| Marriage & Family Therapist | 106H00000X | 131062 | CA | |
| Marriage & Family Therapist | 106H00000X | 156502 | CA | Primary |
Addresses
Primary practice location
5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140
Mailing address
PO Box 4874
Fresno, CA 93744-4874
Phone (323) 205-7088
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
| License | State | Type | Specialty |
|---|---|---|---|
| R1324030918 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| 131062 | CA | MD | Marriage & Family Therapist |
| 156502 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755043200000",
"number": "1922528116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4874",
"city": "FRESNO",
"state": "CA",
"postal_code": "937444874",
"telephone_number": "323-205-7088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 GREAT AMERICA PKWY STE 320",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950541140",
"telephone_number": "323-205-7088",
"fax_number": "833-419-0181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUA",
"first_name": "SERENA",
"middle_name": "SOUKSAKHONE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-20",
"last_updated": "2025-08-13",
"certification_date": "2025-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1324030918",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "131062",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "156502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.