Provider Demographics
NPI:1386409100
Name:AARONSON, ZACH
Entity type:Individual
Prefix:
First Name:ZACH
Middle Name:
Last Name:AARONSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4144 KENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:VIEW PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90008-4810
Mailing Address - Country:US
Mailing Address - Phone:213-440-8865
Mailing Address - Fax:
Practice Address - Street 1:4144 KENWAY AVE
Practice Address - Street 2:
Practice Address - City:VIEW PARK
Practice Address - State:CA
Practice Address - Zip Code:90008-4810
Practice Address - Country:US
Practice Address - Phone:213-440-8865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician