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General NPI Number Information
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NPI Number | 1184245847
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Entity Type | Individual
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Provider Name | JUEN MARC GIANZON ARZADON
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Gender | Male
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 12030 DONNER PASS RD STE 1-433
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City | TRUCKEE
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State | CA
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Zip | 96161-0449
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Country | US
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Telephone | 714-780-2521
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Fax | 714-780-2521
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Provider Business Mailing Address
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Address Line | 12030 DONNER PASS RD STE 1-433
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City | TRUCKEE
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State | CA
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Zip | 96161-0449
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Country | US
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Telephone | 714-780-2521
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Fax | 714-327-0673
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT141856
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License Number State | CA
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