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General NPI Number Information
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NPI Number | 1043516206
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Entity Type | Individual
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Provider Name | MRS. ZORAIDA A. OQUENDO
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Gender | Female
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 573 SOUTH LOOP 3RD ST
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City | FORT IRWIN
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State | CA
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Zip | 92310
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Country | US
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Telephone | 760-380-4042
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Fax | 760-380-4042
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Provider Business Mailing Address
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Address Line | 1401 EL NORTE PKWY SPC 218
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City | SAN MARCOS
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State | CA
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Zip | 92069-2256
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Country | US
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Telephone | 760-429-4083
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Fax | 760-380-4042
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 178001659
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCA 327
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License Number State | MD
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