JOERAY THAVONE MOAN - NPI 1457226474 - Peer Specialist in Stockton, CA

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

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About Joeray Thavone Moan NPPES

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

JOERAY THAVONE MOAN (NPI 1457226474) is an individual peer specialist in Stockton, California, licensed in California (MPSS-VTKGXI) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1457226474

Entity TypeIndividualMale

Primary Taxonomy175T00000X

Provider Legal NameJOERAY THAVONE MOAN

Location Address105 S SAN JOAQUIN STStockton, CA 95202-3206

Mailing Address105 S San Joaquin StStockton, CA 95202-3206 · (209) 953-5466

Phone(209) 953-5466

Sole ProprietorYes

Enumeration DateOctober 8, 2025

Last NPPES UpdateJuly 6, 20262 updates tracked since enumeration

NPPES CertifiedJuly 6, 2026

✔ NPI 1457226474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in CA · MPSS-VTKGXI

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Also ListedCommunity Health WorkerTaxonomy 172V00000X

105 S SAN JOAQUIN ST, Stockton, CA 95202

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Other Providers at the Same Location NPPES 9

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

SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES

Clinic/Center (Mental Health (Including Community Mental Health Center))