Provider Demographics
NPI:1982996328
Name:MORA, ERIKA CHRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:CHRISTINE
Last Name:MORA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:28780 SINGLE OAK DR STE 160
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5528
Mailing Address - Country:US
Mailing Address - Phone:951-676-4193
Mailing Address - Fax:
Practice Address - Street 1:28780 SINGLE OAK DR STE 160
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5528
Practice Address - Country:US
Practice Address - Phone:619-665-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55492363AM0700X
MI5601005965363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical