Healthcare Provider Details

I. General information

NPI: 1548126865
Provider Name (Legal Business Name): JANET ZARAGOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N PEPPER AVE
COLTON CA
92324-1801
US

IV. Provider business mailing address

16102 HARVEY DR
FONTANA CA
92336-2421
US

V. Phone/Fax

Practice location:
  • Phone: 877-873-2762
  • Fax:
Mailing address:
  • Phone: 909-559-7213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95037751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: