Healthcare Provider Details

I. General information

NPI: 1528972098
Provider Name (Legal Business Name): JOSE P ZAVALA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 FRESNO ST
FRESNO CA
93721-1722
US

IV. Provider business mailing address

1161 WOLVERTON WAY W
MADERA CA
93636-9116
US

V. Phone/Fax

Practice location:
  • Phone: 559-457-6056
  • Fax:
Mailing address:
  • Phone: 559-457-6057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: