Healthcare Provider Details

I. General information

NPI: 1497042436
Provider Name (Legal Business Name): AARON ZACHARY WARD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ZACH WARD PH.D.

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 06/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 NORTH HALL, ONE SHIELDS AVE.
DAVIS CA
95616
US

IV. Provider business mailing address

219 NORTH HALL, ONE SHIELDS AVE.
DAVIS CA
95616
US

V. Phone/Fax

Practice location:
  • Phone: 530-752-0871
  • Fax: 530-752-9923
Mailing address:
  • Phone: 530-752-0871
  • Fax: 530-752-9923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY 24276
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: