Healthcare Provider Details

I. General information

NPI: 1679024509
Provider Name (Legal Business Name): MR. ADAM ZUCCATO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 WALNUT ST SUITE G
RED BLUFF CA
96080-3611
US

IV. Provider business mailing address

PO BOX 400
RED BLUFF CA
96080-0400
US

V. Phone/Fax

Practice location:
  • Phone: 530-527-7893
  • Fax:
Mailing address:
  • Phone: 530-527-7893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: