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NPI 1417890120

NPI 1417890120 : AUDRA MONROE MORAN : CHICO, CA

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General NPI Number Information
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    NPI Number           |    1417890120
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    Entity Type          |    Individual 
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    Provider Name        |    AUDRA MONROE MORAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/09/2026
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    Last Update Date     |    04/24/2026
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Provider Practice Location Address
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    Address Line         |    560 COHASSET RD STE 100 
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    City                 |    CHICO
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    State                |    CA
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    Zip                  |    95926-2490
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    Country              |    US
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    Telephone            |    530-739-0502
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6589 JACK HILL DR 
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    City                 |    OROVILLE
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    State                |    CA
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    Zip                  |    95966-3880
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    Country              |    US
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    Telephone            |    530-739-0502
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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        |    372600000X
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    Taxonomy Name        |    Adult Companion
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    License Number       |    
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    License Number State |    CA
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