Healthcare Provider Details

I. General information

NPI: 1003341322
Provider Name (Legal Business Name): VIRGINIA ZARINEBAF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3845 SPRING DR
SPRING VALLEY CA
91977-1030
US

IV. Provider business mailing address

4530 59TH ST
SAN DIEGO CA
92115-3822
US

V. Phone/Fax

Practice location:
  • Phone: 510-694-0092
  • Fax:
Mailing address:
  • Phone: 847-602-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12478
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: