Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Triple Moon Psychotherapy Collective a Licensed Clinical Social Worker

Organization Clinical Social Worker · NPI 1306587837

Triple Moon Psychotherapy Collective a Licensed Clinical Social Worker is a Clinical Social Worker in Garden Grove, California. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

12371 Lewis St Ste 103
Garden Grove, CA 92840-4687
Phone: (949) 868-8255
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1306587837
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amy Le Reve Renderos — Director · (951) 870-1528
Other names Triple Moon Psychotherapy Collective; Triple Moon Psychotherapy Collective A Licensed Social Worker Corp
NPI enumeratedApril 6, 2022
Last updated in NPPESOctober 4, 2023
Certification dateOctober 4, 2023
Mailing address12371 Lewis St Ste 103, Garden Grove, CA 92840-4687

Other providers in Garden Grove