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General NPI Number Information
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NPI Number | 1265325492
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Entity Type | Individual
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Provider Name | ELDER ZAMORA AMFT
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Gender | Male
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 867 N FAIR OAKS AVE
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City | PASADENA
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State | CA
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Zip | 91103-3050
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Country | US
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Telephone | 626-798-6793
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Fax |
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Provider Business Mailing Address
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Address Line | 285 N GARFIELD AVE APT 16B
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City | PASADENA
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State | CA
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Zip | 91101-1551
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Country | US
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Telephone | 909-506-9803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 151177
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License Number State | CA
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