Provider Demographics
NPI:1649715582
Name:ZAMORA-WILLIAMS, MIRANDA (ATC)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:ZAMORA-WILLIAMS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 HICKOK CIR
Mailing Address - Street 2:
Mailing Address - City:ORCUTT
Mailing Address - State:CA
Mailing Address - Zip Code:93455-3705
Mailing Address - Country:US
Mailing Address - Phone:575-973-7951
Mailing Address - Fax:
Practice Address - Street 1:764 HICKOK CIR
Practice Address - Street 2:
Practice Address - City:ORCUTT
Practice Address - State:CA
Practice Address - Zip Code:93455-3705
Practice Address - Country:US
Practice Address - Phone:575-973-7951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-02
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00008032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer