Provider Demographics
NPI:1063881522
Name:ZAMORA, JOHN ERIC
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ERIC
Last Name:ZAMORA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 SIERRA MADRE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-5590
Mailing Address - Country:US
Mailing Address - Phone:775-348-8811
Mailing Address - Fax:775-313-9759
Practice Address - Street 1:315 RECORD ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3327
Practice Address - Country:US
Practice Address - Phone:775-348-8811
Practice Address - Fax:775-313-9759
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health