Provider Demographics
NPI:1972740231
Name:ZUMAS, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:ZUMAS
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 1:3600 CERRILLOS RD STE 303
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2694
Mailing Address - Country:US
Mailing Address - Phone:505-231-7157
Mailing Address - Fax:
Practice Address - Street 1:3600 CERRILLOS RD STE 303
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2694
Practice Address - Country:US
Practice Address - Phone:505-257-8554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM13726731Medicaid