MEDICARE: NAYELI BERENICE ZAMORA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1558818252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAYELI BERENICE ZAMORA

Provider Business Mailing Address
First Line	:	1243 MONTEAGLE DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-4028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1243 MONTEAGLE DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-4028
Country	:	US
Telephone Number	:	408-829-7481
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2016
Last Update Date	:	09/10/2016

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Directions to “ NAYELI BERENICE ZAMORA ” Practice Location

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