Healthcare Provider Details

I. General information

NPI: 1922560655
Provider Name (Legal Business Name): GINA ZOLNIEREK LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 RANCHEROS DR STE 301
SAN MARCOS CA
92069-2993
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 760-471-4073
  • Fax: 619-528-4625
Mailing address:
  • Phone: 916-576-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC5885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: