Healthcare Provider Details

I. General information

NPI: 1679152474
Provider Name (Legal Business Name): ZELEXA-CALIFORNIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 N PALM AVE STE 300
FRESNO CA
93711-5510
US

IV. Provider business mailing address

31153 PLYMOUTH RD STE 105
LIVONIA MI
48150-2134
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-8246
  • Fax: 734-466-5160
Mailing address:
  • Phone: 734-466-5150
  • Fax: 734-466-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ASIL ZAYED
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 734-466-5150