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General NPI Number Information
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NPI Number | 1407927957
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Entity Type | Individual
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Provider Name | LUCILA MORA C.N.M.,N.P.
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1860 PENNSYLVANIA AVE SUITE 300A
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City | FAIRFIELD
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State | CA
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Zip | 94533-3590
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Country | US
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Telephone | 707-438-7600
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Fax | 707-429-8604
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Provider Business Mailing Address
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Address Line | 4315 MELODY LN
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City | VALLEJO
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State | CA
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Zip | 94591-6355
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Country | US
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Telephone | 707-648-1137
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 488965
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 1346
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License Number State | CA
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