Provider Demographics
NPI:1124845169
Name:MOTA, FRANCISCO
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:MOTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 171ST ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-6903
Mailing Address - Country:US
Mailing Address - Phone:515-689-5657
Mailing Address - Fax:
Practice Address - Street 1:2540 106TH ST STE 101
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3736
Practice Address - Country:US
Practice Address - Phone:515-270-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA127694104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker