Healthcare Provider Details

I. General information

NPI: 1508032582
Provider Name (Legal Business Name): ARTHUR BENJAMIN ZINKE LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BEN ZINKE LMFT

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19322 JESSE LN
RIVERSIDE CA
92508-5072
US

IV. Provider business mailing address

6700 N LINDER RD STE 156A #355
MERIDIAN ID
83646
US

V. Phone/Fax

Practice location:
  • Phone: 951-387-4040
  • Fax:
Mailing address:
  • Phone: 626-665-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMF53745
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT-9757
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: