Healthcare Provider Details

I. General information

NPI: 1134462757
Provider Name (Legal Business Name): CLAUDIA MIRNA ZUNIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2013
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PINE AVE
LONG BEACH CA
90813-3124
US

IV. Provider business mailing address

1301 PINE AVE
LONG BEACH CA
90813-3124
US

V. Phone/Fax

Practice location:
  • Phone: 310-987-2859
  • Fax:
Mailing address:
  • Phone: 310-987-2859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: