Healthcare Provider Details

I. General information

NPI: 1245390525
Provider Name (Legal Business Name): JENNIFER ZAPPIN LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 CENTER ST
SANTA CRUZ CA
95060-3808
US

IV. Provider business mailing address

912 CENTER ST
SANTA CRUZ CA
95060-3808
US

V. Phone/Fax

Practice location:
  • Phone: 831-359-3746
  • Fax: 831-429-0103
Mailing address:
  • Phone: 831-359-3746
  • Fax: 831-429-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC9591
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: