Individual provider · Type 1 NPI

Kelly Marie Moore, FNP-BC

Family Nurse Practitioner · Encino, CA

NPI number 1649049305 Active

Practice location

5120 Woodley Ave
Encino, CA 91436-1443

Fax (888) 385-7037

Mailing address

6109 Enfield Pl
Riverside, CA 92506-4712

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95028281 (CA)
Psychiatric/Mental Health Nurse Practitioner 363LP0808X2025085121 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1649049305

Kelly Marie Moore, FNP-BC's National Provider Identifier is 1649049305, issued on Dec 22, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Encino, CA. The record was last updated on Sep 28, 2026.