Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ASW89557 | CA |
N | 1041C0700X | Clinical Social Worker | ASW89557 | CA |
N | 225400000X | Rehabilitation Practitioner |
NPI | 1003475708 |
---|---|
Provider Name | Ana Maria Mora |
First Address | Whittier, CA 90605-3262 |
Second Address | Whittier, CA 90605-3229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2019 |
Last Update Date | 03/07/2019 |