Provider Demographics
NPI:1942968094
Name:ZAMBRANO, DEYANIRA TARANGO (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:DEYANIRA
Middle Name:TARANGO
Last Name:ZAMBRANO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12210 MONTWOOD DR
Mailing Address - Street 2:SUITE 103 # 424
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-1785
Mailing Address - Country:US
Mailing Address - Phone:915-293-1200
Mailing Address - Fax:915-293-1293
Practice Address - Street 1:1400 N EL PASO ST STE C
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3438
Practice Address - Country:US
Practice Address - Phone:915-298-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057147363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health