Healthcare Provider Details

I. General information

NPI: 1952982522
Provider Name (Legal Business Name): ANETTE PAOLA ZEPEDA RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 CORDELL CT STE 100
EL CAJON CA
92020-0914
US

IV. Provider business mailing address

1870 CORDELL CT STE 100
EL CAJON CA
92020-0914
US

V. Phone/Fax

Practice location:
  • Phone: 619-270-7754
  • Fax: 619-448-9711
Mailing address:
  • Phone: 619-270-7754
  • Fax: 619-448-9711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: