MEDICARE: ZOILA ADAMS III

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	101YM0800X	Mental Health Counselor	O469	CA

General Provider Information

NPI Number	:	1942492996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZOILA ADAMS III

Provider Business Mailing Address
First Line	:	2409 N VIA MIRALESTE
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-3154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 N VIA MIRALESTE
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-3154
Country	:	US
Telephone Number	:	760-323-3895
Fax Number	:	760-340-1851

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

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	08/14/2007

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