Provider Demographics
NPI:1588370340
Name:ZUPFER, JUSTIN PATRICK
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:PATRICK
Last Name:ZUPFER
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 1:226 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RIO VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:94571-2116
Mailing Address - Country:US
Mailing Address - Phone:707-841-0092
Mailing Address - Fax:
Practice Address - Street 1:1408 A ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2331
Practice Address - Country:US
Practice Address - Phone:925-978-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)