Individual provider Active NPI

Tom Leroy Moore, MFT

  • Marriage & Family Therapist
  • French Camp, CA
National Provider Identifier
1972705028
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 43541 Issued in CA
Practice address
7000 Michael Canlis Way
French Camp, CA 95231-9781
Phone
(209) 468-5505
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC 43541 CA Primary

Addresses

Primary practice location

7000 Michael Canlis Way
French Camp, CA 95231-9781

Mailing address

21801 E 3Rd Ave
Linden, CA 95236-9736
Phone (209) 887-3218

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
MFC 43541CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972705028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21801 E 3RD AVE",
            "city": "LINDEN",
            "state": "CA",
            "postal_code": "952369736",
            "telephone_number": "209-887-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 MICHAEL CANLIS WAY",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319781",
            "telephone_number": "209-468-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TOM",
        "middle_name": "LEROY",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 43541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in French Camp, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.