Healthcare Provider Details

I. General information

NPI: 1033155569
Provider Name (Legal Business Name): NICHOLAS J. ZIRPOLO PH. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 11/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 EL CAMINO WAY SUITE B
PALO ALTO CA
94306-4006
US

IV. Provider business mailing address

4161 EL CAMINO WAY SUITE B
PALO ALTO CA
94306-4006
US

V. Phone/Fax

Practice location:
  • Phone: 650-494-1215
  • Fax: 650-494-7272
Mailing address:
  • Phone: 650-494-1215
  • Fax: 650-494-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY11597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: