Provider Demographics
NPI:1508272626
Name:JOHN, ZAMARA
Entity Type:Individual
Prefix:
First Name:ZAMARA
Middle Name:
Last Name:JOHN
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 1:960 W 17TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-3572
Mailing Address - Country:US
Mailing Address - Phone:714-547-1404
Mailing Address - Fax:717-455-0467
Practice Address - Street 1:960 W 17TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3572
Practice Address - Country:US
Practice Address - Phone:714-547-1404
Practice Address - Fax:717-455-0467
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor