Provider Demographics
NPI:1386108215
Name:PERKINS, ZACHARY JAMES (MS, MA)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JAMES
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1232
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:96008-1232
Mailing Address - Country:US
Mailing Address - Phone:530-356-6820
Mailing Address - Fax:
Practice Address - Street 1:1647 HARTNELL AVE STE 14
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2268
Practice Address - Country:US
Practice Address - Phone:530-605-3221
Practice Address - Fax:530-410-6995
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT110910106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty