Healthcare Provider Details

I. General information

NPI: 1790086320
Provider Name (Legal Business Name): RACHEL LEE ZAVARELLA M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 LA PURISSIMA WAY
SACRAMENTO CA
95819-2138
US

IV. Provider business mailing address

224 LA PURISSIMA WAY
SACRAMENTO CA
95819-2138
US

V. Phone/Fax

Practice location:
  • Phone: 408-899-9281
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPCI 147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: