SHANNON MOORE - NPI 1386095453 - Psychologist in San Diego, CA

Q: What is Shannon Moore's NPI number?

The NPI number for Shannon Moore is 1386095453. It was assigned to this individual provider in the NPPES registry on June 29, 2016.

Q: What is Shannon Moore's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Moore was last updated on June 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

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About Shannon Moore NPPES

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

SHANNON MOORE (NPI 1386095453) is an individual clinical provider in San Diego, California, licensed in California (PSY20947) and active in the NPI registry since June 2016.

NPPES Registry Identity

NPI1386095453

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameSHANNON MOORE

Location Address480 ALTA RDSan Diego, CA 92179-0001

Mailing AddressPo Box 12641La Jolla, CA 92039-2641 · (858) 453-8509 · Fax (858) 453-8509

Phone(619) 661-6500

Sole ProprietorNo

Enumeration DateJune 29, 2016

✔ NPI 1386095453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · PSY20947

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

480 ALTA RD, San Diego, CA 92179

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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. RAFAEL ELIAS OLIVARES CHAYEB

Psychologist (Clinical)