Provider Demographics
NPI:1770038648
Name:ZAMORA, REBECCA J (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 ATRISCO DR NW
Mailing Address - Street 2:APT 218
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1490
Mailing Address - Country:US
Mailing Address - Phone:575-418-8587
Mailing Address - Fax:
Practice Address - Street 1:3501 ATRISCO DR NW
Practice Address - Street 2:APT 218
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1490
Practice Address - Country:US
Practice Address - Phone:575-418-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-06497A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical