Healthcare Provider Details

I. General information

NPI: 1629798582
Provider Name (Legal Business Name): MORA PSYCHOLOGY SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W 3RD ST APT 1005
LOS ANGELES CA
90013-1119
US

IV. Provider business mailing address

453 S SPRING ST STE 400 PMB 45
LOS ANGELES CA
90013-2074
US

V. Phone/Fax

Practice location:
  • Phone: 213-453-7616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEJANDRA MORA SANCHEZ
Title or Position: PRESIDENT
Credential: PSYD
Phone: 213-453-7616