Healthcare Provider Details
I. General information
NPI: 1669186052
Provider Name (Legal Business Name): JESSICA ZARIF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/10/2023
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7000 SUNNE LN STE 112
WALNUT CREEK CA
94597-3613
US
IV. Provider business mailing address
5300 CONCERTO CIR
CONCORD CA
94521-3250
US
V. Phone/Fax
- Phone: 925-360-6092
- Fax:
- Phone: 925-360-6092
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2255A2300X |
| Taxonomy | Athletic Trainer |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: