DR. SHAVON CHERELLE MOORE MD
NPI 1053682773
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Diego, CA

Q: What is Shavon Moore's NPI number?

The NPI number for Shavon Moore is 1053682773. It was assigned to this individual provider in the NPPES registry on January 26, 2012.

Q: What is Shavon Moore's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Shavon Moore was last updated on February 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 26, 2012PECOS Enrolled

200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

NPPES record last updated: February 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 6, 2023, Sep 29, 2021, Jul 17, 2018 and 2 more (5 updates tracked since 2016).

On this page

About Dr. Shavon Cherelle Moore Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHAVON CHERELLE MOORE MD (NPI 1053682773) is an individual child & adolescent psychiatry provider in San Diego, California, licensed in California (A152789) and active in the NPI registry since January 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1053682773

Entity TypeIndividualFemale

Primary Taxonomy2084P0804X

Provider Legal NameDR. SHAVON CHERELLE MOORECredential: MD

Location Address200 W ARBOR DRSan Diego, CA 92103-9000

Mailing AddressPo Box 232410San Diego, CA 92193-2410

Phone(800) 926-8273

Fax(888) 539-8781

Sole ProprietorNo

Enumeration DateJanuary 26, 2012

Last NPPES UpdateFebruary 6, 20235 updates tracked since enumeration

NPPES CertifiedFebruary 6, 2023

✔ NPI 1053682773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in CA · A152789

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License A152789 (CA)

200 W ARBOR DR, San Diego, CA 92103

Open in Google Maps ↗

Secondary Practice Location 1

Location 13020 Childrens WaySan Diego, CA 92123-4223 · Phone (858) 576-1700

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shavon Cherelle Moore Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RAMIN MOTARJEMI M.D.

Internal Medicine (Geriatric Medicine)