JACOB MOON (NPI# 1831655422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831655422 |
| Entity Type | Individual |
| Full Name | JACOB MOON |
| Credential | MA, LMFT |
| Practice Address |
23331 El Toro Rd Ste 208 Lake Forest CA 92630-4883 |
| Mailing Address |
92 Birchwood Ln Aliso Viejo CA 92656-2925 |
| Practice Telephone | 9493917790 |
| Mailing Telephone | 9492454191 |
| Mailing Fax Number | 8445336952 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2020-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 121296 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17111 Beach Blvd Ste 205, Huntington Beach, CA 926475947 | 7146541570 | 8445336952 |
| Street Address |
23331 EL TORO RD STE 208 |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-4883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444971 | Ravonkavi Services | Clinic/Center | 23331 El Toro Rd Ste 208, Lake Forest, CA 92630-4883 | 2020-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| 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 |
|---|---|---|---|---|
| 1619479979 | Debra Woog | Marriage & Family Therapist | 23591 El Toro Rd Ste 163, Lake Forest, CA 92630-4765 | 2018-03-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1851839609 | Adelina Velasquez | Marriage & Family Therapist | 23361 El Toro Road, Suite 215, Lake Forest, CA 92630-6921 | 2017-02-01 |
| 1053742635 | Elina Kamrany | Marriage & Family Therapist | 23591 El Toro Rd Ste 207, Lake Forest, CA 92630-4700 | 2013-12-06 |
| 1023312295 | Anne Louise Martin | Marriage & Family Therapist | 23861 El Toro Rd, 7th Floor, Lake Forest, CA 92630-4732 | 2011-01-03 |
| 1225346141 | Darcy Robert Greene | Marriage & Family Therapist | 24551 Raymond Way Ste 286, Lake Forest, CA 92630-4495 | 2010-09-14 |
| 1487969267 | Yu-tung Sharon Lin | Marriage & Family Therapist | 100 Saunders Rd, Suite 150, Lake Forest, IL 60045-2502 | 2010-08-17 |
| 1770813743 | Tiffany Renee Agra | Marriage & Family Therapist | 23832 Rockfield Blvd Ste 120, Lake Forest, CA 92630-2870 | 2010-01-13 |
| 1922231620 | Nadia Teymoorian | Marriage & Family Therapist | 23591 El Toro Rd Ste 294, Lake Forest, CA 92630-4767 | 2009-08-27 |
| 1386811776 | Bridgman Psychological Services, P.C. | Marriage & Family Therapist | 22792 Centre Dr Ste 290, Lake Forest, CA 92630-6304 | 2008-05-14 |
| Find all providers in LAKE FOREST | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
Please comment or provide details below to improve the information on JACOB MOON.
| 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.