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General NPI Number Information
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NPI Number | 1710275425
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Entity Type | Individual
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Provider Name | SANDRA M. ZAVALA NP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 11711 LIVINGSTON RD
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-5151
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Country | US
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Telephone | 909-566-0445
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Fax |
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Provider Business Mailing Address
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Address Line | 12457 ROSE PATH CIR
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City | FAIRFAX
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State | VA
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Zip | 22033-6235
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Country | US
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Telephone | 703-728-3338
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R144617
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024169503
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95008678
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN221556
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0991802
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License Number State | CO
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