Provider Demographics
NPI:1215147509
Name:RETTIG-ZUCCHI, RONALD MARIO (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MARIO
Last Name:RETTIG-ZUCCHI
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 BANCROFT AVE
Mailing Address - Street 2:STE. 125C
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2403
Mailing Address - Country:US
Mailing Address - Phone:925-833-3300
Mailing Address - Fax:925-833-3322
Practice Address - Street 1:7200 BANCROFT AVE
Practice Address - Street 2:STE. 125C
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2403
Practice Address - Country:US
Practice Address - Phone:925-833-3300
Practice Address - Fax:925-833-3322
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30095106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2584OtherACBHC STAFF NUMBER