Provider Demographics
NPI:1396342747
Name:ZARATE, VANNESA
Entity type:Individual
Prefix:
First Name:VANNESA
Middle Name:
Last Name:ZARATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N PARK VISTA ST SPC 88
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-3728
Mailing Address - Country:US
Mailing Address - Phone:714-605-1084
Mailing Address - Fax:
Practice Address - Street 1:320 N PARK VISTA ST SPC 88
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-3728
Practice Address - Country:US
Practice Address - Phone:714-605-1084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician