Healthcare Provider Details

I. General information

NPI: 1578633491
Provider Name (Legal Business Name): JOANNA L ZYGMONT PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOANNA L ACENTARES PSY.D.

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 VICENTE ST
SAN FRANCISCO CA
94116-2923
US

IV. Provider business mailing address

400 ESTUDILLO AVE STE 200
SAN LEANDRO CA
94577-4900
US

V. Phone/Fax

Practice location:
  • Phone: 415-681-3211
  • Fax:
Mailing address:
  • Phone: 510-281-0727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number24120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: