Healthcare Provider Details

I. General information

NPI: 1346916160
Provider Name (Legal Business Name): EMILY ZAVALA-AGUILAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 SUTTERVILLE RD
SACRAMENTO CA
95820-1093
US

IV. Provider business mailing address

2701 DEL PASO RD STE 130
SACRAMENTO CA
95835-2306
US

V. Phone/Fax

Practice location:
  • Phone: 916-452-3981
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number145463
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10397
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number128525
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: