Healthcare Provider Details

I. General information

NPI: 1912364639
Provider Name (Legal Business Name): MAYRA ALEJANDRA ZAMORA LPCC 9256
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 KUHIO AVE APT 1602
HONOLULU HI
96815-5061
US

IV. Provider business mailing address

9528 MIRAMAR RD UNIT 6190
SAN DIEGO CA
92126-4533
US

V. Phone/Fax

Practice location:
  • Phone: 619-663-6990
  • Fax:
Mailing address:
  • Phone: 619-663-6990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: