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General NPI Number Information
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NPI Number | 1376008649
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Entity Type | Individual
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Provider Name | ZACHARY ABBOTT
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Gender | Male
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 421 E MORRIS AVE
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City | MODESTO
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State | CA
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Zip | 95354-0437
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Country | US
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Telephone | 209-552-2807
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Fax |
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Provider Business Mailing Address
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Address Line | 8898 RODDEN RD
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City | OAKDALE
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State | CA
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Zip | 95361-8777
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Country | US
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Telephone | 650-201-0306
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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