Provider Demographics
NPI:1063115277
Name:ORELLANA ZAMORA, ALISSON KIMBERLY
Entity type:Individual
Prefix:
First Name:ALISSON
Middle Name:KIMBERLY
Last Name:ORELLANA ZAMORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 SAN JACINTO RD
Mailing Address - Street 2:UNIT 107
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-3128
Mailing Address - Country:US
Mailing Address - Phone:951-674-9243
Mailing Address - Fax:
Practice Address - Street 1:265 SAN JACINTO RIVER RD-
Practice Address - Street 2:SUITE 107
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4400
Practice Address - Country:US
Practice Address - Phone:951-674-9243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator