Healthcare Provider Details

I. General information

NPI: 1437872306
Provider Name (Legal Business Name): NATHAN ZAMORA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NATE ZAMORA

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 CHURCH AVE STE 3
CHULA VISTA CA
91910-2718
US

IV. Provider business mailing address

272 CHURCH AVE STE 3
CHULA VISTA CA
91910-2718
US

V. Phone/Fax

Practice location:
  • Phone: 619-737-2989
  • Fax:
Mailing address:
  • Phone: 619-398-2156
  • Fax: 619-398-2168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: