Healthcare Provider Details

I. General information

NPI: 1902620925
Provider Name (Legal Business Name): MARIFE ZACARIAS WEBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 S ANITA DR
ORANGE CA
92868-3355
US

IV. Provider business mailing address

1320 W PEARL ST
ANAHEIM CA
92801-5941
US

V. Phone/Fax

Practice location:
  • Phone: 949-749-2500
  • Fax:
Mailing address:
  • Phone: 714-780-1174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number265150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: