Healthcare Provider Details

I. General information

NPI: 1568651347
Provider Name (Legal Business Name): JOSEPH ANTHONY ZIZZO M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: J. ANTHONY ZIZZO M.A.

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SHASTA ST
REDDING CA
96001-0417
US

IV. Provider business mailing address

1880 SHASTA ST
REDDING CA
96001-0417
US

V. Phone/Fax

Practice location:
  • Phone: 530-248-3000
  • Fax: 530-248-3098
Mailing address:
  • Phone: 530-248-3047
  • Fax: 530-248-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF 54435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: