Healthcare Provider Details

I. General information

NPI: 1417155367
Provider Name (Legal Business Name): GENNY B ZAPATA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GENY B ZAPATA PSY.D.

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 CESAR CHAVEZ AVE SUITE 230
LOS ANGELES CA
90033
US

IV. Provider business mailing address

5823 YORK BLVD STE 3
LOS ANGELES CA
90042-2634
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-1100
  • Fax: 323-226-1101
Mailing address:
  • Phone: 323-255-5643
  • Fax: 323-254-2158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: