Healthcare Provider Details

I. General information

NPI: 1891518262
Provider Name (Legal Business Name): ELIZABETH MOJICA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N TUSTIN AVE
SANTA ANA CA
92705-3528
US

IV. Provider business mailing address

12312 TWINTREE AVE
GARDEN GROVE CA
92840-3819
US

V. Phone/Fax

Practice location:
  • Phone: 714-545-5550
  • Fax: 714-708-2588
Mailing address:
  • Phone: 714-376-7348
  • Fax: 714-376-7348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95032686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: