Individual provider Active NPI

Maria Zambrano

  • Child Mental Illness Respite Care
  • Glendale, AZ
National Provider Identifier
1174681829
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Mental Illness Respite CareTaxonomy code 385HR2055X
License
11355 Issued in AZ
Practice address
5603 W Shangri la Rd
Glendale, AZ 85304-3851
Phone
(623) 979-1150
NPI assigned
Dec 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 11355 AZ Primary

Addresses

Primary practice location

5603 W Shangri la Rd
Glendale, AZ 85304-3851

Mailing address

5603 W Shangri la Rd
Glendale, AZ 85304-3851
Phone (623) 979-1150

Other identifiers 1

IdentifierTypeStateIssuer
116658OtherAZACCCHS ID. NUMBER

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11355AZMDChild Mental Illness Respite Care

Practice roles

OrganizationSpecialtyStatusNew patients
Devereux Foster Care Respite Care, Mental Illness, Child Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174681829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 W SHANGRI LA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853043851",
            "telephone_number": "623-979-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 W SHANGRI LA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853043851",
            "telephone_number": "623-979-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMBRANO",
        "first_name": "MARIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "11355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCCHS ID. NUMBER",
            "identifier": "116658",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.