Provider Demographics
NPI:1437308996
Name:ZAMACONA, GABRIEL KIM
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:KIM
Last Name:ZAMACONA
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:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:POINT REYES STATION
Mailing Address - State:CA
Mailing Address - Zip Code:94956-0331
Mailing Address - Country:US
Mailing Address - Phone:415-663-8231
Mailing Address - Fax:
Practice Address - Street 1:100 6TH STREET
Practice Address - Street 2:
Practice Address - City:POINT REYES STATION
Practice Address - State:CA
Practice Address - Zip Code:94956-0000
Practice Address - Country:US
Practice Address - Phone:415-663-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health