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General NPI Number Information
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NPI Number | 1043024284
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Entity Type | Individual
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Provider Name | NICHOLAS MORA MS, ATC, CES
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Gender | Male
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 2380 LAS PLUMAS AVE
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City | OROVILLE
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State | CA
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Zip | 95966-6999
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Country | US
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Telephone | 530-538-2310
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 HOBART ST UNIT 2
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City | CHICO
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State | CA
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Zip | 95926-4541
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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