| Doctor Name: | MR. JAIME MORA |
| NPI Number: | 1093141244 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 31946 Mission Trl Ste B Lake Elsinore, CA - 925304539 |
| Business Phone Number: | 9512457663 |
| Business Fax Number: | 9516746431 |
| Mailing Address: | 31946 Mission Trl Ste B, LAKE ELSINORE |
| State: | CA |
| Postal Code: | 925304539 |
| Phone Number: | 9512457663 |
| Fax Number: | 9516746431 |
| NPI Enumeration Date: | 09/19/2013 |
| NPI Last Update Date: | 02/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |