Healthcare Provider Details

I. General information

NPI: 1710331251
Provider Name (Legal Business Name): RITA ZITO L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3172 WALFORD AVE STE 1
EUREKA CA
95503-4898
US

IV. Provider business mailing address

PO BOX 452
CUTTEN CA
95534-9900
US

V. Phone/Fax

Practice location:
  • Phone: 707-599-0822
  • Fax: 707-269-0651
Mailing address:
  • Phone: 707-599-0822
  • Fax: 707-269-0651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW68913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: