MEDICARE: MS. MICAELA MORGAN MOTA LMFT AND LEP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	LEP4554	CA
2	106H00000X	Marriage & Family Therapist	LMFT156093	CA

General Provider Information

NPI Number	:	1619410339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICAELA MORGAN MOTA LMFT AND LEP

Provider Business Mailing Address
First Line	:	2956 MULLENS DR
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-2645
Country	:	US
Telephone Number	:	510-778-4304
Fax Number	:

Provider Business Practice Location Address
First Line	:	2956 MULLENS DR
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-2645
Country	:	US
Telephone Number	:	510-778-4304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	04/14/2026

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