Healthcare Provider Details

I. General information

NPI: 1932402161
Provider Name (Legal Business Name): RODNEY WAYNE ZIKAN MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9554 CROSSROADS DR
REDDING CA
96003-6813
US

IV. Provider business mailing address

9560 CROSSROADS DR
REDDING CA
96003-6813
US

V. Phone/Fax

Practice location:
  • Phone: 530-524-6684
  • Fax:
Mailing address:
  • Phone: 530-524-6684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC33898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: