Healthcare Provider Details

I. General information

NPI: 1164210548
Provider Name (Legal Business Name): JESSICA ZAVALZA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 W BELL RD
GLENDALE AZ
85308-3639
US

IV. Provider business mailing address

6363 W BELL RD
GLENDALE AZ
85308-3639
US

V. Phone/Fax

Practice location:
  • Phone: 657-201-2036
  • Fax:
Mailing address:
  • Phone: 657-201-2036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number22043
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: