Healthcare Provider Details

I. General information

NPI: 1215486485
Provider Name (Legal Business Name): ASHLEY LOPEZ ZAMORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2016
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 FREEDOM BLVD STE F
WATSONVILLE CA
95076-2752
US

IV. Provider business mailing address

1430 FREEDOM BLVD STE F
WATSONVILLE CA
95076-2752
US

V. Phone/Fax

Practice location:
  • Phone: 831-763-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: