Healthcare Provider Details

I. General information

NPI: 1760073746
Provider Name (Legal Business Name): ANNA MARIE GONZALES ZAMORA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11633 VICTORY BLVD STE 100
NORTH HOLLYWOOD CA
91606-3513
US

IV. Provider business mailing address

9405 S EASTERN AVE APT 2073
LAS VEGAS NV
89123-3996
US

V. Phone/Fax

Practice location:
  • Phone: 888-530-4415
  • Fax:
Mailing address:
  • Phone: 818-835-2880
  • Fax: 833-471-5322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number835593
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95034919
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: