Healthcare Provider Details

I. General information

NPI: 1114194842
Provider Name (Legal Business Name): MS. KIMBERLY MARY ZAPALAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N CHURCH ST
VISALIA CA
93291-5009
US

IV. Provider business mailing address

310 N CHURCH ST
VISALIA CA
93291-5009
US

V. Phone/Fax

Practice location:
  • Phone: 559-734-6042
  • Fax: 559-635-4788
Mailing address:
  • Phone: 559-734-6042
  • Fax: 559-635-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: