Keelah Moore

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

D2116347 Issued in CA

Practice address

3206 Lorenzo Ave
Oakland, CA 94619-1220

Phone

(510) 342-8088

NPI assigned

Jan 9, 2024

Last updated

Jan 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1942071030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 LORENZO AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946191220",
            "telephone_number": "510-342-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 LORENZO AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946191220",
            "telephone_number": "510-342-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KEELAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "D2116347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda Irene Moore, FNP
• Howard Moore III
• John Moore III, PHD
• Joshua Moore, DC
• Justin Earl Moore, MD
• Keith Bronson Moore Jr., LVN
• Kristine Marie Moore, MFTI
• La Tonya Crystal-Kelly Moore, MHRS
• Lee Porscha Mechelle Moore, LCSW
• Louis Matthews Moore, PH.D.

• Behavior Technician in Oakland, CA
• Providers in Oakland, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.