Provider Demographics
NPI:1831948546
Name:CASANOVA-CARMONA, IRIS ZUYAMI
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:ZUYAMI
Last Name:CASANOVA-CARMONA
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 1:1563 MISSION ST FL 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2592
Mailing Address - Country:US
Mailing Address - Phone:415-503-2331
Mailing Address - Fax:
Practice Address - Street 1:1563 MISSION ST FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2592
Practice Address - Country:US
Practice Address - Phone:415-503-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker