Healthcare Provider Details

I. General information

NPI: 1760717664
Provider Name (Legal Business Name): WILLIAM TUCKER ZAPPAS A.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 FRANKLIN ST 4TH FLOOR
OAKLAND CA
94612-3487
US

IV. Provider business mailing address

1814 FRANKLIN ST FL 4
OAKLAND CA
94612-3487
US

V. Phone/Fax

Practice location:
  • Phone: 510-318-6102
  • Fax:
Mailing address:
  • Phone: 510-318-6102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW21980110
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: