Healthcare Provider Details

I. General information

NPI: 1144873167
Provider Name (Legal Business Name): ABIGAIL ZEPEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 08/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10428 LOWER AZUSA RD
EL MONTE CA
91731-1208
US

IV. Provider business mailing address

10 W BAY STATE ST #944
ALHAMBRA CA
91802
US

V. Phone/Fax

Practice location:
  • Phone: 626-652-0755
  • Fax:
Mailing address:
  • Phone: 626-652-0755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: