Provider Demographics
NPI:1376981167
Name:ZAMORA, CLIFFORD CHRIS
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:CHRIS
Last Name:ZAMORA
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 1:9877 LANZAROTE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-7515
Mailing Address - Country:US
Mailing Address - Phone:702-672-4634
Mailing Address - Fax:
Practice Address - Street 1:911 N BUFFALO DR UNIT 213
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0381
Practice Address - Country:US
Practice Address - Phone:702-942-1774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health