Healthcare Provider Details

I. General information

NPI: 1982561908
Provider Name (Legal Business Name): JOSE ZAVALA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8521 A ST
OAKLAND CA
94621-1619
US

IV. Provider business mailing address

1701 18TH ST
OAKLAND CA
94607-1658
US

V. Phone/Fax

Practice location:
  • Phone: 510-729-7723
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number240153194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: