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General NPI Number Information
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NPI Number | 1508687567
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Entity Type | Individual
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Provider Name | JOHN ANTHONY ZAPATA CAPRC, CPSP
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Gender | Male
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 6774 RIO GRANDE AVE
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City | PORTAGE
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State | IN
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Zip | 46368-2592
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Country | US
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Telephone | 219-939-4187
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Fax |
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Provider Business Mailing Address
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Address Line | 6774 RIO GRANDE AVE
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City | PORTAGE
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State | IN
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Zip | 46368-2592
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Country | US
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Telephone | 219-689-2153
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | CAPRC1-5741
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 4156
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License Number State | IN
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