Healthcare Provider Details

I. General information

NPI: 1407472046
Provider Name (Legal Business Name): SANDRA ISABEL ZUNIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 MARINA BLVD APT 14
SAN LEANDRO CA
94577-4017
US

IV. Provider business mailing address

2601 MARINA BLVD APT 14
SAN LEANDRO CA
94577-4017
US

V. Phone/Fax

Practice location:
  • Phone: 510-999-1603
  • Fax:
Mailing address:
  • Phone: 510-999-1603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: