Healthcare Provider Details

I. General information

NPI: 1104627983
Provider Name (Legal Business Name): SLOANE ZUCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11027 BURBANK BLVD
NORTH HOLLYWOOD CA
91601-2431
US

IV. Provider business mailing address

11027 BURBANK BLVD
NORTH HOLLYWOOD CA
91601-2431
US

V. Phone/Fax

Practice location:
  • Phone: 818-985-8323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number743851
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: