Provider Demographics
NPI:1902786817
Name:ZALDIVAR, ANDREW C
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:ZALDIVAR
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 1:2365 MCKNIGHT RD N
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2238
Mailing Address - Country:US
Mailing Address - Phone:651-370-2364
Mailing Address - Fax:
Practice Address - Street 1:2365 MCKNIGHT RD N
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2238
Practice Address - Country:US
Practice Address - Phone:651-370-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker