Provider Demographics
NPI:1104280635
Name:ZUBIATE, PRISCILLA (CACDII # A050280818)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:ZUBIATE
Suffix:
Gender:F
Credentials:CACDII # A050280818
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-4322
Mailing Address - Country:US
Mailing Address - Phone:661-327-9376
Mailing Address - Fax:
Practice Address - Street 1:1021 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-2433
Practice Address - Country:US
Practice Address - Phone:661-765-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA050280818101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)