Healthcare Provider Details

I. General information

NPI: 1427446863
Provider Name (Legal Business Name): JULIA ZUCHKOV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24321 COUNTY RD. 96
DAVIS CA
95616
US

IV. Provider business mailing address

PO BOX 431
DAVIS CA
95617-0431
US

V. Phone/Fax

Practice location:
  • Phone: 530-753-1653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: