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General NPI Number Information
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NPI Number | 1699289629
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Entity Type | Individual
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Provider Name | NICOLE MOJICA
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Gender | Female
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 3801 UNIVERSITY AVE STE 270
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City | RIVERSIDE
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State | CA
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Zip | 92501-3272
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Country | US
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Telephone | 951-200-8575
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 UNIVERSITY AVE STE 270
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City | RIVERSIDE
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State | CA
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Zip | 92501-3272
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Country | US
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Telephone | 951-200-8575
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Fax | 951-530-3997
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95043640
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95010939
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License Number State | CA
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