Individual provider Active NPI

Natasha Marietta Jade Zamora, CNM

  • Advanced Practice Midwife
  • Indio, CA
National Provider Identifier
1417523374
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236458 Issued in CA
Practice address
81719 Dr Carreon Blvd Ste C-1
Indio, CA 92201-5518
Phone
(760) 777-4067
Fax
(760) 777-4096
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 236458 CA Primary
Registered Nurse 163W00000X RN60968301 WA
Registered Nurse 163W00000X 95282852 CA

Addresses

Primary practice location

81719 Dr Carreon Blvd Ste C-1
Indio, CA 92201-5518

Mailing address

81719 Dr Carreon Blvd Ste C-1
Indio, CA 92201-5518
Phone (760) 777-4067

Other practice location 1

79440 Highway 111 Ste 105
LA Quinta, CA 92253-4500
Phone (760) 777-4067

Other practice location 2

47111 Monroe St
Indio, CA 92201-6799
Phone (760) 347-6191

Other names 1

  • Natasha Nepomuceno Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260409001714 CA Practitioner - Certified Nurse Midwife (CNM) 5799250510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
La Quinta, CA 92248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
95282852CAMDRegistered Nurse
RN60968301WAMDRegistered Nurse
236458CAMDAdvanced Practice Midwife

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1417523374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81719 DR CARREON BLVD STE C-1",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015518",
            "telephone_number": "760-777-4067",
            "fax_number": "760-777-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81719 DR CARREON BLVD STE C-1",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015518",
            "telephone_number": "760-777-4067",
            "fax_number": "760-777-4096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79440 Highway 111 Ste 105",
            "address_purpose": "LOCATION",
            "city": "LA Quinta",
            "state": "CA",
            "postal_code": "922534500",
            "country_code": "US",
            "telephone_number": "760-777-4067",
            "fax_number": "760-777-4096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47111 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922016799",
            "country_code": "US",
            "telephone_number": "760-347-6191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "NATASHA",
        "middle_name": "MARIETTA JADE",
        "name_prefix": "Dr.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236458",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60968301",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95282852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATASHA",
            "last_name": "NEPOMUCENO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.