Healthcare Provider Details

I. General information

NPI: 1679372122
Provider Name (Legal Business Name): ALLISON ZONSIUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 N LAKE AVE
PASADENA CA
91104-4521
US

IV. Provider business mailing address

1001 FREMONT AVE # 128
SOUTH PASADENA CA
91030-3224
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-0706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: