Healthcare Provider Details

I. General information

NPI: 1578819926
Provider Name (Legal Business Name): TERESAMARIA PEREZ ZAVALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4470 W SUNSET BLVD STE 107
LOS ANGELES CA
90027-6309
US

IV. Provider business mailing address

2037 W BULLARD AVE # 133
FRESNO CA
93711-1200
US

V. Phone/Fax

Practice location:
  • Phone: 323-798-7413
  • Fax:
Mailing address:
  • Phone: 559-313-9279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number88605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: