Healthcare Provider Details

I. General information

NPI: 1124874748
Provider Name (Legal Business Name): NICHOLAS ALEXIS ZOFFEL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 BISSELL AVE
RICHMOND CA
94801-3135
US

IV. Provider business mailing address

2426 7TH AVE
SACRAMENTO CA
95818-3912
US

V. Phone/Fax

Practice location:
  • Phone: 408-835-6474
  • Fax:
Mailing address:
  • Phone: 408-835-6474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: