Individual
SUSAN MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1216 W AVENUE J, LANCASTER, CA 93534-2944
(661) 341-3495
Mailing address
1216 W AVENUE J, LANCASTER, CA 93534-2944
(661) 341-3495
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-CESPLV
CA
Other
Enumeration date
11/14/2013
Last updated
06/26/2023
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