MEDICARE: ZUMAYA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	09924043	CO

General Provider Information

NPI Number	:	1629428982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZUMAYA

Provider Business Mailing Address
First Line	:	31481 UPPER BEAR CREEK RD
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-7818
Country	:	US
Telephone Number	:	559-307-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1143 SANTA FE DR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-3543
Country	:	US
Telephone Number	:	559-307-1800
Fax Number	:

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	GLADYS R VILLA
Credential	:
Telephone Number	:	559-307-1800

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	09/06/2023

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Directions to “ZUMAYA ” Practice Location

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