Healthcare Provider Details

I. General information

NPI: 1407785686
Provider Name (Legal Business Name): JESSICA ZARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 DOW AVE STE 114
TUSTIN CA
92780-7247
US

IV. Provider business mailing address

336 W ORANGEWOOD AVE APT B
ANAHEIM CA
92802-4797
US

V. Phone/Fax

Practice location:
  • Phone: 714-731-4668
  • Fax:
Mailing address:
  • Phone: 714-492-4917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21749
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: