KEVIN PATRICK MOODY (NPI# 1124543970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124543970 |
| Entity Type | Individual |
| Full Name | KEVIN PATRICK MOODY |
| Practice Address |
251 Llewellyn Ave Campbell CA 95008 |
| Mailing Address |
14301 New Jersey Ave San Jose CA 95124-2804 |
| Practice Telephone | 4087612286 |
| Mailing Telephone | 4085159577 |
| Enumeration Date | 2017-08-12 |
| Last Update Date | 2020-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | AMFT118244 | CA | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 171M00000X | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 499 Loma Alta Ave, Los Gatos, CA 950306227 | 4085159577 |
| Street Address |
251 LLEWELLYN AVE |
| City | CAMPBELL |
| State | CA |
| Zip Code | 95008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811093917 | Larry Bryon Hanville Jr. | Marriage & Family Therapist | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2006-09-15 |
| 1093316341 | Justin Johael Arellano Francisco | Licensed Vocational Nurse | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-11-03 |
| 1952909681 | Milton Velez | Case Manager/Care Coordinator | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-10-14 |
| 1114525425 | Kelly Amber Escobedo | Student in an Organized Health Care Education/Training Program | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-10-09 |
| 1104433770 | Nelson Vieira Brasil | Case Manager/Care Coordinator | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-09-28 |
| 1568079184 | Megan Michelle Lavond | Behavior Technician | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-09-28 |
| 1134730120 | Sara Jane Vargus | Behavior Technician | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-08-12 |
| 1992314876 | Samantha Medeiros | Student in an Organized Health Care Education/Training Program | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-07-27 |
| 1932718038 | Nereyda Plancarte | Counselor | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-07-24 |
| 1285242842 | Christine Benetua | Student in an Organized Health Care Education/Training Program | 251 Llewellyn Ave, Campbell, CA 95008-1940 | 2020-07-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298380 | Kerry Lynn Osteen | Massage Therapist | 3579 S Bascom Ave, Apt 5, Campbell, CA 95008 | 2020-09-02 |
| 1164057550 | Francesca Dalangin | Physical Therapist | 163 E. Hamilton Avenue, Campbell, CA 95008 | 2020-03-06 |
| 1144790767 | Haley Brucato | Behavior Technician | 131 Rose Court Apt. 21, Campbell, CA 95008 | 2018-11-27 |
| 1740765809 | Crystal-xuanthao Nguyen Curammeng | Licensed Vocational Nurse | 251 Llwelyn Ave, Campbell, CA 95008 | 2018-09-25 |
| 1841799236 | Gabrielle Suzanne Buma | Physician Assistant | Uplift Family Services 251 Llewellyn Ave, Campbell, CA 95008 | 2018-02-12 |
| 1093214660 | Toni Lynn Clementi | Marriage & Family Therapist | 116 E. Campbell Ave, Campbell, CA 95008 | 2018-02-08 |
| 1184132573 | My Hanh Thi Nguyen | Behavioral Analyst | 1440 Theresa Avenue, Campbell, CA 95008 | 2018-01-19 |
| 1346770948 | Stephanie Michele Klahold | Pharmacist | 100 North San Tomas Aquino Road, Campbell, CA 95008 | 2017-06-15 |
| 1578095378 | Elina Josephson | Marriage & Family Therapist | 155 E Campbell Ave Ste 117, Campbell, CA 95008 | 2017-03-30 |
| 1912448408 | Suzane Mitchualmacauley | Licensed Vocational Nurse | 251 Llewelyn Ave, Uplift Family Services, Campbell, CA 95008 | 2017-03-16 |
| Find all providers in zip 95008 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427679489 | Kaitlin Eastland | Marriage & Family Therapist | 155 E Campbell Ave Ste 220, Campbell, CA 95008-2062 | 2020-04-30 |
| 1285253443 | Mary Jean Walton | Marriage & Family Therapist | 400 Llewellyn Ave, Campbell, CA 95008-1967 | 2020-04-08 |
| 1093340218 | Mary Elizabeth Kane | Marriage & Family Therapist | 621 E Campbell Ave Ste 17, Campbell, CA 95008-2137 | 2020-03-09 |
| 1871133462 | Jennifer Boehlke | Marriage & Family Therapist | 197 E Hamilton Ave, Campbell, CA 95008-0261 | 2020-01-10 |
| 1336703529 | First Always Best Therapy | Marriage & Family Therapist | 45 N 1st St # Gf, Campbell, CA 95008-2033 | 2019-04-24 |
| 1790240596 | Minagrace Drake | Marriage & Family Therapist | 2155 S Bascom Ave Ste 110, Campbell, CA 95008-3200 | 2019-02-05 |
| 1093214660 | Toni Lynn Clementi | Marriage & Family Therapist | 116 E. Campbell Ave, Campbell, CA 95008 | 2018-02-08 |
| 1578095378 | Elina Josephson | Marriage & Family Therapist | 155 E Campbell Ave Ste 117, Campbell, CA 95008 | 2017-03-30 |
| 1962957126 | Kimberly Jane Mccord | Marriage & Family Therapist | 1925 Winchester Blvd Ste 204, Campbell, CA 95008-1038 | 2016-08-17 |
| 1346644424 | Nicholas Moises Sanchez | Marriage & Family Therapist | 1215 Fewtrell Dr, Campbell, CA 95008-2426 | 2014-10-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.