Provider Demographics
NPI:1275245227
Name:ZAMORA, MONSERRATH
Entity Type:Individual
Prefix:
First Name:MONSERRATH
Middle Name:
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13425 CATTAIL CT
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-8705
Mailing Address - Country:US
Mailing Address - Phone:951-880-8203
Mailing Address - Fax:
Practice Address - Street 1:13425 CATTAIL CT
Practice Address - Street 2:TOPAZ
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392
Practice Address - Country:US
Practice Address - Phone:951-880-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174200000XOther Service ProvidersMeals