MEDICARE: SANTIAGO CHAMORRO ZUNIGA M.S. BCBA

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	103K00000X	Behavior Analyst	1-25-78882	CA

General Provider Information

NPI Number	:	1629882105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANTIAGO CHAMORRO ZUNIGA M.S. BCBA

Provider Business Mailing Address
First Line	:	17343 GRANADA AVE
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92335-4926
Country	:	US
Telephone Number	:	909-436-7043
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 3RD ST STE 103
Second Line	:
City	:	NORCO
State	:	CA
Zip	:	92860-2672
Country	:	US
Telephone Number	:	714-683-5876
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	02/04/2025

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