Provider Demographics
NPI:1538126370
Name:ZANE, PAMELA K (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:K
Last Name:ZANE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 E OCEAN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-6102
Mailing Address - Country:US
Mailing Address - Phone:757-671-9115
Mailing Address - Fax:757-481-6311
Practice Address - Street 1:1745 CAMELOT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2435
Practice Address - Country:US
Practice Address - Phone:757-481-6000
Practice Address - Fax:757-481-6311
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001089103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2104992OtherMAMSI
VA463359OtherANTHEM BLUE CROSS
VAS76181Medicare UPIN
VA000786B67Medicare ID - Type Unspecified