Provider Demographics
NPI:1598113417
Name:ZARATE, JOSE MAURICIO
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MAURICIO
Last Name:ZARATE
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 1:3870 ROSIN CT STE 130
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1647
Mailing Address - Country:US
Mailing Address - Phone:916-923-0105
Mailing Address - Fax:
Practice Address - Street 1:3870 ROSIN CT STE 130
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1647
Practice Address - Country:US
Practice Address - Phone:916-923-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17576101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional