Individual
JOSE MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Mailing address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
35208
CA
167G00000X
Licensed Psychiatric Technician
Primary
35208
CA
Other
Enumeration date
12/22/2023
Last updated
08/01/2025
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