Provider Demographics
NPI:1548093701
Name:ZAMARO, JULIA SOTO
Entity type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:SOTO
Last Name:ZAMARO
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 1:898 ABIGAIL CT
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-3500
Mailing Address - Country:US
Mailing Address - Phone:208-716-1558
Mailing Address - Fax:
Practice Address - Street 1:898 ABIGAIL CT
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-3500
Practice Address - Country:US
Practice Address - Phone:208-716-1558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDGC236877E172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty