Healthcare Provider Details

I. General information

NPI: 1598334260
Provider Name (Legal Business Name): VANESSA ZOLUD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15107 VANOWEN ST
VAN NUYS CA
91405-4597
US

IV. Provider business mailing address

20140 HART ST
WINNETKA CA
91306-3518
US

V. Phone/Fax

Practice location:
  • Phone: 818-902-5258
  • Fax:
Mailing address:
  • Phone: 818-486-5282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95096293
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1598334260
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95021585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: