Healthcare Provider Details

I. General information

NPI: 1669977989
Provider Name (Legal Business Name): GIULIANA ZLATAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4929 WILSHIRE BLVD STE 510
LOS ANGELES CA
90010-3820
US

IV. Provider business mailing address

901 VIA CARTAGO APT 201
RIVERSIDE CA
92507-6238
US

V. Phone/Fax

Practice location:
  • Phone: 909-908-4564
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: