Healthcare Provider Details

I. General information

NPI: 1861147365
Provider Name (Legal Business Name): ZACHARY HAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 S MAYFLOWER AVE STE 220
MONROVIA CA
91016-4066
US

IV. Provider business mailing address

1333 S MAYFLOWER AVE STE 220
MONROVIA CA
91016-4066
US

V. Phone/Fax

Practice location:
  • Phone: 818-241-6780
  • Fax:
Mailing address:
  • Phone: 206-474-0725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWIA.SC.70110854
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: