SHANNON VICTORIA MOORE PHD
NPI 1639881253
Psychologist - Clinical in Vacaville, CA

Q: What is Shannon Moore's NPI number?

The NPI number for Shannon Moore is 1639881253. It was assigned to this individual provider in the NPPES registry on December 14, 2022.

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 December 14, 2022. 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 December 14, 2022PECOS Enrolled

1 QUALITY DR, VACAVILLE, CA 95688(707) 624-2830 Get Directions Write a Review

NPPES record last updated: December 14, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Shannon Victoria Moore Phd NPPES

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

SHANNON VICTORIA MOORE PHD (NPI 1639881253) is an individual clinical provider in Vacaville, California, licensed in California (33838) and active in the NPI registry since December 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639881253

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameSHANNON VICTORIA MOORECredential: PHD

Location Address1 QUALITY DRVacaville, CA 95688-9494

Mailing Address3438 1st AveSacramento, CA 95817-2015 · (908) 963-6776

Phone(707) 624-2830

Sole ProprietorYes

Enumeration DateDecember 14, 2022

NPPES CertifiedDecember 14, 2022

✔ NPI 1639881253 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 · 33838

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.

1 QUALITY DR, Vacaville, CA 95688

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Victoria Moore Phd 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95688 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$191.95 typical visit price

range $65.02 – $191.95

Typical copayment $47.98 (range $16.25 – $47.98)

Most-billed visit code 99205

Established Patient

$113.05 typical visit price

range $21.86 – $157.69

Typical copayment $28.26 (range $5.46 – $39.42)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DONALD BRADNER WARD CRNA

Nurse Anesthetist, Certified Registered

1 QUALITY DR
VACAVILLE, CA 95688

Solano County (707) 624-4207

MS. ELAINE GARDNER PT

Physical Therapist

1 QUALITY DR
VACAVILLE, CA 95688

Solano County (707) 624-4000

SAMANTHA LYNN TORRES-RAMONDO

Respiratory Therapist, Registered

1 QUALITY DR
VACAVILLE, CA 95688

Solano County (707) 624-1850

WES R WILTSE DO

Physical Medicine & Rehabilitation

1 QUALITY DR, B36
VACAVILLE, CA 95688

Solano County (707) 684-3840

MRS. NATALIA FELDMAN OTR/L

Occupational Therapist

1 QUALITY DR
VACAVILLE, CA 95688

Solano County (707) 624-4000

DR. TERAH HENNICK MD

Orthopaedic Surgery

1 QUALITY DR
VACAVILLE, CA 95688

Solano County (707) 624-4000

ANKUR NITIN KAPADIA MD

Family Medicine

1 QUALITY DR
VACAVILLE, CA 95688

Solano County (707) 624-4000

KAISER PERMANENTE

Clinic/Center (Adult Mental Health)

1 QUALITY DR
VACAVILLE, CA 95688

Solano County (707) 624-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Moore's NPI number?

The NPI number for Shannon Moore is 1639881253. It was assigned to this individual provider in the NPPES registry on December 14, 2022.

Where is Shannon Moore located?

Shannon Moore practices at 1 Quality Dr, Vacaville, CA 95688. The listed phone number is (707) 624-2830.

What is Shannon Moore's specialty?

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

Is Shannon Moore enrolled in Medicare?

Yes. Shannon Moore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Moore was last updated on December 14, 2022. 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.