Jacqueline Nicole Mourra, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2023153882 Issued in CA

Practice address

416 Broadway
Chula Vista, CA 91910-4304

Phone

(619) 427-1144

Fax

(619) 427-1185

NPI assigned

Jul 31, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Balboa Nephrology Medical Group IncGroup PAC ID 9638164015, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sharp Chula Vista Medical Center Hospital, Chula Vista, CA, CCN 050222

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Balboa Nephrology Medical Group, Inc.

  • Nephrology Physician
  • San Diego, CA
  • NPI 1316997505

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Balboa Nephrology Medical Group,Inc.

  dba San Diego Access and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
  • NPI 1598276404
  NPD

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

• Sharp Chula Vista Medical Center

  • General Acute Care Hospital
  • Chula Vista, CA
  • NPI 1396728630
  Care Compare affiliation

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1235968785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9373 HAZARD WAY STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231226",
            "telephone_number": "858-810-8000",
            "fax_number": "858-268-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BROADWAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104304",
            "telephone_number": "619-427-1144",
            "fax_number": "619-427-1185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900571944",
            "country_code": "US",
            "telephone_number": "888-499-9303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOURRA",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "2023153882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Moss, MFT
• Marina Mosson, LCSW
• Jorge Alberto Mota Jr., M.D.
• Motiva Family Therapists and Behavioral Services Inc (Motiva Associates)
• Roderick I Mountain, M.D.
• Mehran Moussavian, DO
• Richard Scott Mowry, DMD
• Stephanie Moy, PHARM D
• Brian Moyer, PA-C
• Malak Mtasher

• Family Nurse Practitioner in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.