Provider Demographics
NPI:1689191025
Name:ZARZA, TAMIRA (CNM)
Entity Type:Individual
Prefix:
First Name:TAMIRA
Middle Name:
Last Name:ZARZA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:TAMIRA
Other - Middle Name:
Other - Last Name:FULCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5389 ESSEX DR
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-6278
Mailing Address - Country:US
Mailing Address - Phone:209-777-3787
Mailing Address - Fax:
Practice Address - Street 1:500 W HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:FRENCH CAMP
Practice Address - State:CA
Practice Address - Zip Code:95231-9693
Practice Address - Country:US
Practice Address - Phone:209-468-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-26
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235884176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife