Healthcare Provider Details

I. General information

NPI: 1083419501
Provider Name (Legal Business Name): VERONICA SUSANA ZEPEDA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18300 ROSCOE BLVD
NORTHRIDGE CA
91325-4105
US

IV. Provider business mailing address

128 LAUREL RIDGE DR
SIMI VALLEY CA
93065-7395
US

V. Phone/Fax

Practice location:
  • Phone: 818-885-8500
  • Fax:
Mailing address:
  • Phone: 805-624-0027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033854
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: