CYRUS A MOAZAM (NPI# 1558574814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558574814 |
| Entity Type | Individual |
| Full Name | CYRUS A MOAZAM |
| Credential | PHD |
| Practice Address |
9267 Greenback Ln B-98 Orangevale CA 95662-4863 |
| Mailing Address |
767 Heritage Pl Folsom CA 95630-6242 |
| Practice Telephone | 9165059151 |
| Practice Fax Number | 9169887864 |
| Mailing Telephone | 9165059151 |
| Mailing Fax Number | 9169887864 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2012-04-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
PSY13748 | CA | Behavioral Health & Social Service Providers |
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PSY13748 | CA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY13748 | CA | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
PSY13748 | CA | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
PSY13748 | CA | Behavioral Health & Social Service Providers |
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
PSY13748 | CA | Behavioral Health & Social Service Providers |
| Street Address |
9267 GREENBACK LN B-98 |
| City | ORANGEVALE |
| State | CA |
| Zip Code | 95662-4863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215990478 | Capital Dialysis Partnership | Clinic/Center | 9267 Greenback Ln, Ste A2, Orangevale, CA 95662-4864 | 2006-04-10 |
| 1114453107 | Elite Health Care Services, LLC | Home Health | 9267 Greenback Ln, Suite B-1, Orangevale, CA 95662-4863 | 2017-05-11 |
| 1588064646 | Advanced Practice Primary Care A Registered Nursing Corporation | Clinic/Center | 9267 Greenback Ln, Suite C2, Orangevale, CA 95662-4863 | 2014-08-26 |
| 1366787269 | Supportive Psychological Care | Clinic/Center | 9267 Greenback Ln, B98, Orangevale, CA 95662-4863 | 2012-12-03 |
| 1063669307 | Ernest Jarman IIi | Psychologist | 9267 Greenback Ln, #b98, Orangevale, CA 95662-4863 | 2008-08-19 |
| 1255599783 | Karen E. Kelly | Psychologist | 9267 Greenback Ln, Suite B-98, Orangevale, CA 95662-4863 | 2008-05-30 |
| 1598954265 | Progressive Therapy Clinic | Clinic/Center | 9267 Greenback Ln, Suite C-2, Orangevale, CA 95662-4863 | 2007-10-18 |
| 1396896916 | Wenda Jeanne Merz | Physical Therapist | 9267 Greenback Ln, Suite C-2, Orangevale, CA 95662-4863 | 2007-01-12 |
| 1164588216 | Georgia Lyn Brown I | Physical Therapist | 9267 Greenback Ln, Orangevale, CA 95662-4863 | 2006-12-30 |
| 1801985189 | Ross William Lauger | Nurse Practitioner | 9267 Greenback Ln, Suite C-2, Orangevale, CA 95662-4863 | 2006-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174027338 | Susan Kaefer | Physical Therapist | 9525 Tremont Court, Orangevale, CA 95662 | 2018-03-22 |
| 1568918209 | William Parker Henderson | Specialist/Technologist | 9201 Madison Ave #235, Orangevale, CA 95662 | 2016-09-01 |
| 1558665745 | Gary C White Optometric Corporation | Optometrist | 8836 Greenback Lane Ste F, Orangevale, CA 95662 | 2011-01-02 |
| 1679634877 | Troy M Mauvais | Chiropractor | 8836 Greenback Ln, Ste B, Orangevale, CA 95662 | 2006-12-12 |
| 1821169830 | Peter W Worth | Dentist | 9197 Greenback Lane, Suite A, Orangevale, CA 95662 | 2006-11-13 |
| 1497763866 | Peter D Lopresti | Chiropractor | 9198 Greenback Lane, Suite 112, Orangevale, CA 95662 | 2006-08-03 |
| 1245454297 | Cheryl Ann Lee | Massage Therapist | 9198 Greenback Ln, #208, Orangevale, CA 95662 | 2007-04-12 |
| 1144735614 | Ondrea Lynn Cumbra | Behavior Technician | 8783 Steven Ave, Orangevale, CA 95662-2110 | 2017-12-06 |
| 1760963540 | Rajena Atwal | Pharmacist | 10040 Hadleigh Dr, Orangevale, CA 95662-2234 | 2018-08-28 |
| 1134580228 | Paradise Oaks Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 7441 Hickory Ave, Orangevale, CA 95662-2305 | 2016-03-16 |
| Find all providers in zip 95662 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746650 | Alexandria Marie Schick | Psychologist | 2785 Cold Springs Rd Apt 31, Placerville, CA 95667-3240 | 2020-10-08 |
| 1841804853 | Nia Mayers Franklin | Psychologist | 8940 S Hobart Blvd, Los Angeles, CA 90047-3615 | 2020-09-08 |
| 1871104307 | Erania Marie Martin-lang | Psychologist | 13329 Arbor Park Ln, Moreno Valley, CA 92553-6916 | 2020-08-10 |
| 1366051070 | Shellie Renae Higuera | Psychologist | 5059 Day Dr, Fairfield, CA 94533-6597 | 2020-07-28 |
| 1730706979 | Oak Forest Recovery Center, Inc. | Psychologist | 5655 Lindero Canyon Rd Ste 425, Westlake Village, CA 91362-4046 | 2020-07-04 |
| 1861016842 | Valley Harvest Church of Merced | Psychologist | 557 W 26th St, Merced, CA 95340-2825 | 2020-06-04 |
| 1629691993 | Franklin Clifford Wimberly | Psychologist | 10 Pleasant Walk, Aliso Viejo, CA 92656-4266 | 2020-05-21 |
| 1790325694 | Pacific Forensic Psychology Associates, Inc | Psychologist | 19230 Sonoma Highway, Building 200, Sonoma, CA 95476 | 2020-01-09 |
| 1386282762 | Danielle Wischenka | Psychologist | 155 E Campbell Ave Ste 219, Campbell, CA 95008-2062 | 2019-12-16 |
| 1528525326 | Sylvia Cary | Psychologist | 4650 Sepulveda Blvd Apt 201, Sherman Oaks, CA 91403-2462 | 2019-02-28 |
| Find all providers with the same taxonomy | ||||
| City | ORANGEVALE |
| Zip Code | 95662 |
Please comment or provide details below to improve the information on CYRUS A MOAZAM.
| 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.