Provider Demographics
NPI:1982407128
Name:MOLLIQUE, ZANQUONDRIA ASHANIQUE
Entity type:Individual
Prefix:
First Name:ZANQUONDRIA
Middle Name:ASHANIQUE
Last Name:MOLLIQUE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-3413
Mailing Address - Country:US
Mailing Address - Phone:925-529-7909
Mailing Address - Fax:
Practice Address - Street 1:4849 LONE TREE WAY STE C
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8644
Practice Address - Country:US
Practice Address - Phone:925-462-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician