Healthcare Provider Details

I. General information

NPI: 1093632861
Provider Name (Legal Business Name): FATIMA ELIZABETH ZERMENO DE SANTOS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 DANNON VW SW STE 4103
ATLANTA GA
30331-2159
US

IV. Provider business mailing address

5550 HILLCREST DR
UNION CITY GA
30291-1078
US

V. Phone/Fax

Practice location:
  • Phone: 404-346-3471
  • Fax:
Mailing address:
  • Phone: 678-373-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPN39993
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: