Healthcare Provider Details

I. General information

NPI: 1164382750
Provider Name (Legal Business Name): CESAR ALEJANDRO ZAPATA MORENO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2025
Last Update Date: 11/15/2025
Certification Date: 11/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3288 EL CAJON BLVD STE 2
SAN DIEGO CA
92104-1430
US

IV. Provider business mailing address

3288 EL CAJON BLVD STE 2
SAN DIEGO CA
92104-1430
US

V. Phone/Fax

Practice location:
  • Phone: 619-521-5720
  • Fax:
Mailing address:
  • Phone: 619-521-5720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: