Individual provider Active NPI

Justin Mora, FNP

  • Family Nurse Practitioner
  • Santa Maria, CA
National Provider Identifier
1063299717
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027200 Issued in CA
Practice address
316 S Stratford Ave Ste B
Santa Maria, CA 93454-5908
Phone
(805) 332-8446
Fax
(805) 332-8483
NPI assigned
Sep 14, 2023
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95027200 CA Primary

Addresses

Primary practice location

316 S Stratford Ave Ste B
Santa Maria, CA 93454-5908

Mailing address

2271 S Depot St
Santa Maria, CA 93455-1216
Phone (805) 922-0561

Other practice location 1

135 Cimarron Way
Arroyo Grande, CA 93420-5674
Phone (805) 264-6690

Other practice location 2

1102 E Clark Ave Ste 120A
Santa Maria, CA 93455-5175
Phone (805) 332-8185

Other practice location 3

877 Oak Park Blvd
Pismo Beach, CA 93449-3292
Phone (805) 474-8450

Other practice location 4

217 W Central Ave
Lompoc, CA 93436-2830
Phone (805) 735-4292

Other practice location 5

5920 West Mall
Atascadero, CA 93422-4232
Phone (805) 466-0676

Other practice location 6

2271 S Depot St
Santa Maria, CA 93455-1216
Phone (805) 922-0561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240108000985 CA Practitioner - Nurse Practitioner 9830540566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Ynez River Physicians PCGroup PAC ID 7911241229, 21 clinicians

Practice addresses (Care Compare)

1515 E Ocean Ave
Lompoc, CA 93436-7092
Phone (805) 737-3300

2271 S Depot St
Santa Maria, CA 93455-1216
Phone (805) 922-0561

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95027200CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers Current Accepting new patients
Santa Ynez River Physicians, PC CurrentSince Nov 27, 2023 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Feb 5, 2024 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Feb 5, 2024 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

5920 West Mall
Atascadero, CA 93422
Phone (805) 466-0676

500 Old River Rd
Ste 200
Bakersfield, CA 93311
Phone (661) 663-6429

1515 E Ocean Ave
Lompoc, CA 93436
Phone (805) 737-3300

2901 N Ventura Rd
Ste 110
Oxnard, CA 93036
Phone (805) 981-6163

877 Oak Park Blvd
Pismo Beach, CA 93449
Phone (805) 473-2200

1102 E Clark Ave
Ste 120A
Santa Maria, CA 93455
Phone (805) 332-8185

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

2271 S Depot St
Santa Maria, CA 93455
Phone (805) 739-3805

316 S Stratford Ave
Ste B
Santa Maria, CA 93454
Phone (805) 332-8446

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1063299717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 S DEPOT ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551216",
            "telephone_number": "805-922-0561",
            "fax_number": "805-922-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S STRATFORD AVE STE B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545908",
            "telephone_number": "805-332-8446",
            "fax_number": "805-332-8483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Cimarron Way",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934205674",
            "country_code": "US",
            "telephone_number": "805-264-6690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 E Clark Ave Ste 120A",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934555175",
            "country_code": "US",
            "telephone_number": "805-332-8185",
            "fax_number": "805-332-8186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "877 Oak Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934493292",
            "country_code": "US",
            "telephone_number": "805-474-8450",
            "fax_number": "805-474-8454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Lompoc",
            "state": "CA",
            "postal_code": "934362830",
            "country_code": "US",
            "telephone_number": "805-735-4292",
            "fax_number": "805-735-4293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5920 West Mall",
            "address_purpose": "LOCATION",
            "city": "Atascadero",
            "state": "CA",
            "postal_code": "934224232",
            "country_code": "US",
            "telephone_number": "805-466-0676",
            "fax_number": "805-466-4862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2271 S Depot St",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934551216",
            "country_code": "US",
            "telephone_number": "805-922-0561",
            "fax_number": "805-922-0083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORA",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-14",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.