Healthcare Provider Details

I. General information

NPI: 1154965994
Provider Name (Legal Business Name): ANAHI MORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3629 SANTA ANITA AVE
EL MONTE CA
91731
US

IV. Provider business mailing address

3629 SANTA ANITA AVE
EL MONTE CA
91731-2449
US

V. Phone/Fax

Practice location:
  • Phone: 626-993-3000
  • Fax:
Mailing address:
  • Phone: 626-993-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: