KANDICE MOORE MS, PPS
NPI 1609462316
Counselor - Professional in Santa Clara, CA

Q: What is Kandice Moore's NPI number?

The NPI number for Kandice Moore is 1609462316. It was assigned to this individual provider in the NPPES registry on December 16, 2020.

Q: What is Kandice Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Kandice Moore was last updated on November 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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 December 16, 2020PECOS Enrolled

5201 GREAT AMERICA PKWY STE 320, SANTA CLARA, CA 95054(323) 205-7088 Get Directions Write a Review

NPPES record last updated: November 15, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 15, 2024, Jan 13, 2021, Dec 16, 2020 (3 updates tracked since 2020).

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About Kandice Moore Ms, Pps NPPES

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

KANDICE MOORE MS, PPS (NPI 1609462316) is an individual professional provider in Santa Clara, California, licensed in California (15842) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609462316

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKANDICE MOORECredential: MS, PPS

Location Address5201 GREAT AMERICA PKWY STE 320Santa Clara, CA 95054-1140

Mailing Address9447 Friant StRancho Cucamonga, CA 91730-4025 · (909) 697-6096

Phone(323) 205-7088

Sole ProprietorNo

Enumeration DateDecember 16, 2020

Last NPPES UpdateNovember 15, 20243 updates tracked since enumeration

NPPES CertifiedNovember 15, 2024

✔ NPI 1609462316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in CA · 15842

5201 GREAT AMERICA PKWY STE 320, Santa Clara, CA 95054

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kandice Moore Ms, Pps 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.

Medicare Billing Reassignment

Medicare enrollment records show Kandice Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sud Specialty Group - Ca

0.7 mi

Addiction Medicine

4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054

Reassigned Medicare billing, California enrollment
1,607 clinicians in this Medicare group

NPI 1972138238 (323) 205-7088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MRS. DEBORAH MARIE BOUCHER-CARTER

Marriage & Family Therapist