Healthcare Provider Details

I. General information

NPI: 1437731387
Provider Name (Legal Business Name): ZACHARY PAUL ZUCKER MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 09/01/2024
Certification Date: 09/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 MURRIETA BLVD
LIVERMORE CA
94550-4111
US

IV. Provider business mailing address

220 S LIVERMORE AVE UNIT 453
LIVERMORE CA
94551-3621
US

V. Phone/Fax

Practice location:
  • Phone: 925-315-5269
  • Fax:
Mailing address:
  • Phone: 925-315-5269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number147892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: