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Deactivated NPI 1790117653 Deactivated / Inactive NPI Male Practitioner

Eley Moua , BS

Counselor • Stockton, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Eley Moua has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 02, 2013
NPI Deactivation Date November 01, 2023
Total Practice Duration ~10 Years of Practice (2013 – 2023)

Professional Overview & Biography Verified Profile Summary

Eley Moua, BS was a registered Counselor practicing in Stockton, CA. Throughout an active medical career spanning 10 years, Eley Moua provided care at the practice location at 7620 N EL DORADO ST until profile deactivation on 2023-11-01.

Practice Location & Contact Primary Location

Practice Address

7620 N El Dorado St
105

Stockton, CA 952072146

Telephone 2096760333

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Stockton, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 4.0 Yrs
State Avg: 12.9 Yrs
Regional Practice Density
144 Specialists

Practicing in Stockton, CA (14303 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Shannon Ward , RN

Registered Nurse

NPI 1235475047

Registered Nurse

Beverly Scott-Washington

Registered Nurse - Psychiatric/Mental Health

NPI 1235580861
Haley Madrigal

Counselor - Addiction (Substance Use Disorder)

NPI 1316355860

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 01, 2023

Record deactivated on November 01, 2023

NPI Profile Active August 02, 2013

NPI status registered as active in NPPES database

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Updated Practice Location August 02, 2013

Registered at 7620 N EL DORADO ST, 105, STOCKTON, CA 952072146 (Tel: 2096760333)

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Updated Business Mailing Address August 02, 2013

Registered at 7620 N EL DORADO ST, 105, STOCKTON, CA 952072146 (Tel: 2096760333)

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Provider Name / Credentials Updated August 02, 2013

Recorded as ELEY MOUA, B.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 02, 2013

Counselor

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Initial NPI Registration & Enumeration August 02, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790117653
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 02, 2013
Last Update: August 02, 2013
Deactivation Date: November 01, 2023

Mailing Address

7620 N El Dorado St, 105

Stockton, CA 952072146

Phone: 2096760333

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.