Healthcare Provider Details

I. General information

NPI: 1609251909
Provider Name (Legal Business Name): RACHEL ZIZZA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 HARRISON AVE
EUREKA CA
95501-3217
US

IV. Provider business mailing address

PO BOX 7187
EUREKA CA
95502-7187
US

V. Phone/Fax

Practice location:
  • Phone: 707-442-0478
  • Fax:
Mailing address:
  • Phone: 707-267-5598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number835390
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95012038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: