Healthcare Provider Details

I. General information

NPI: 1417890120
Provider Name (Legal Business Name): AUDRA MONROE MORAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUDRA MONROE HUFFORD

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 COHASSET RD STE 100
CHICO CA
95926-2490
US

IV. Provider business mailing address

6589 JACK HILL DR
OROVILLE CA
95966-3880
US

V. Phone/Fax

Practice location:
  • Phone: 530-739-0502
  • Fax:
Mailing address:
  • Phone: 530-739-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: