Healthcare Provider Details

I. General information

NPI: 1477239713
Provider Name (Legal Business Name): VICTOR ZACHARIOU MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21000 PLUMMER ST
CHATSWORTH CA
91311-4903
US

IV. Provider business mailing address

417 S HILL ST APT 742
LOS ANGELES CA
90013-2371
US

V. Phone/Fax

Practice location:
  • Phone: 818-882-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: