Healthcare Provider Details

I. General information

NPI: 1720222151
Provider Name (Legal Business Name): LUZ M ZEPEDA LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 JEFFERSON ST
DELANO CA
93215-2238
US

IV. Provider business mailing address

1019 JEFFERSON ST
DELANO CA
93215-2238
US

V. Phone/Fax

Practice location:
  • Phone: 661-721-0463
  • Fax: 661-721-0482
Mailing address:
  • Phone: 661-721-0463
  • Fax: 661-721-0482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberPT34634
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: