Healthcare Provider Details

I. General information

NPI: 1013738251
Provider Name (Legal Business Name): ALEX EDUARDO ZAPIEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 W MAIN ST
MERCED CA
95340-4438
US

IV. Provider business mailing address

5304 CENTRAL AVE
ATWATER CA
95301-9632
US

V. Phone/Fax

Practice location:
  • Phone: 209-725-1060
  • Fax:
Mailing address:
  • Phone: 209-777-9774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: