Healthcare Provider Details

I. General information

NPI: 1922815364
Provider Name (Legal Business Name): STEPHANIE ZAPATA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 PICO BLVD
SANTA MONICA CA
90405-1326
US

IV. Provider business mailing address

PO BOX 61709
SANTA BARBARA CA
93160-1709
US

V. Phone/Fax

Practice location:
  • Phone: 805-284-1970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95030527
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: