Healthcare Provider Details

I. General information

NPI: 1083026603
Provider Name (Legal Business Name): BIANCA ANGELICA MOCHA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BIANCA ANGELICA AGUILAR LPC

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 W UNION HILLS DR
PHOENIX AZ
85027-5163
US

IV. Provider business mailing address

PO BOX 417147
BOSTON MA
02241-7147
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-7088
  • Fax: 833-419-0181
Mailing address:
  • Phone: 518-952-8140
  • Fax: 518-952-8287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19772
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: