Provider Demographics
NPI:1386794170
Name:ZARZANA, JOELLE MARIE (OD)
Entity type:Individual
Prefix:
First Name:JOELLE
Middle Name:MARIE
Last Name:ZARZANA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 TRANCAS ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3040
Mailing Address - Country:US
Mailing Address - Phone:707-252-2020
Mailing Address - Fax:707-252-0329
Practice Address - Street 1:895 TRANCAS ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3040
Practice Address - Country:US
Practice Address - Phone:707-252-2020
Practice Address - Fax:707-252-0329
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12679T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA012379Medicaid
CASD012510Medicare PIN
CAV07881Medicare UPIN