Healthcare Provider Details

I. General information

NPI: 1790811248
Provider Name (Legal Business Name): ROBERTO ZARATE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 N FAIR OAKS AVE SUITE 301
PASADENA CA
91103-3069
US

IV. Provider business mailing address

PO BOX 247
PASADENA CA
91102-0247
US

V. Phone/Fax

Practice location:
  • Phone: 626-405-4001
  • Fax: 818-301-7443
Mailing address:
  • Phone: 626-405-4001
  • Fax: 818-301-7443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY26446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: