Provider Demographics
NPI:1881307619
Name:ZAMORA-ENRIQUEZ, GLORIA
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:ZAMORA-ENRIQUEZ
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 1:1865 E 8TH ST APT 116
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4162
Mailing Address - Country:US
Mailing Address - Phone:530-965-6241
Mailing Address - Fax:
Practice Address - Street 1:1865 E 8TH ST APT 116
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4162
Practice Address - Country:US
Practice Address - Phone:530-965-6241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician