Healthcare Provider Details

I. General information

NPI: 1497006878
Provider Name (Legal Business Name): CLEO K ZIFOVSKI CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 ETHAN WAY
SACRAMENTO CA
95825-2214
US

IV. Provider business mailing address

7965 KINGSWOOD DR APT 254
CITRUS HEIGHTS CA
95610-7725
US

V. Phone/Fax

Practice location:
  • Phone: 732-207-1795
  • Fax:
Mailing address:
  • Phone: 732-207-1795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: