Individual provider Active NPI

Patricia Mora, BCBA

  • Behavior Analyst
  • Camarillo, CA
National Provider Identifier
1093276503
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11934402 Issued in CA
Practice address
400 Mobil Ave
Camarillo, CA 93010-6338
Phone
(323) 240-1257
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 11934402 CA Primary

Addresses

Primary practice location

400 Mobil Ave
Camarillo, CA 93010-6338

Mailing address

6620 Ira Ave
Bell Gardens, CA 90201-3116
Phone (323) 819-0218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11934402CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Functionfirstaba Behavior Analyst CurrentSince Sep 8, 2024 Accepting new patients
Developmental Pathways Inc Behavior Analyst Past Accepting new patients
Quantum Behavioral Solutions, Inc. Past Accepting new patients

Locations

2571 Saturn Ave
Huntington Park, CA 90255

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1093276503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 IRA AVE",
            "city": "BELL GARDENS",
            "state": "CA",
            "postal_code": "902013116",
            "telephone_number": "323-819-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106338",
            "telephone_number": "323-240-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "PATRICIA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11934402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.