Healthcare Provider Details

I. General information

NPI: 1912575101
Provider Name (Legal Business Name): BELEN MORA-NAVARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 CLAREMONT AVE
OAKLAND CA
94618-1033
US

IV. Provider business mailing address

5220 CLAREMONT AVE
OAKLAND CA
94618-1033
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: