Cristobal Zamora, L.C.S.W.

Individual provider Active NPI Clinical Social Worker · Wauwatosa, WI

NPI 1164523007 · NPPES record last updated May 5, 2008

Key facts

NPI
1164523007
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
7185-123 (WI)
Practice address
10045 W Lisbon Ave
Suite 200
Wauwatosa, WI 53222-2446
Phone
(414) 358-7144
Fax
(414) 358-7158
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Past Accepting new patients
Alternatives in Psychological Consultation, S.C. Past
since Sep 28, 2015
Accepting new patients
Catholic Charities Diocese of Gary Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7185-123 WI Yes

Addresses

Primary practice location

10045 W Lisbon Ave
Suite 200
Wauwatosa, WI 53222-2446

Mailing address

10045 W Lisbon Ave
Suite 200
Wauwatosa, WI 53222-2446
Phone (414) 358-7144

Other identifiers

IdentifierTypeStateIssuer
40991700MedicaidWI
7185-123OtherWIL.C.S.W.

Other providers in Wauwatosa, WI

All providers in Wauwatosa, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.