{
"Npi": {
"NPI": "1932999349",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MOORE",
"FirstName": "CETH",
"MiddleName": "CEITH",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "AMFT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "9919 N CANYON CREEK LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRESNO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93730-1243",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-475-4418",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1224 E MICHIGAN AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FRESNO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93704-5731",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-892-9744",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/08/2025",
"LastUpdateDate": "06/26/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "145971",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}