Healthcare Provider Details

I. General information

NPI: 1972740231
Provider Name (Legal Business Name): DIANA ZUMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 CERRILLOS RD STE 303
SANTA FE NM
87507-2694
US

IV. Provider business mailing address

3600 CERRILLOS RD STE 303
SANTA FE NM
87507-2694
US

V. Phone/Fax

Practice location:
  • Phone: 505-257-8554
  • Fax:
Mailing address:
  • Phone: 505-231-7157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: