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NPI Code Detail

MEDICARE: MISS CLEO K ZIFOVSKI CADC II

MEDICARE: MISS CLEO K ZIFOVSKI CADC II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1497006878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CLEO K ZIFOVSKI CADC II
Provider Business Mailing Address
First Line : 7965 KINGSWOOD DR APT 254
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-7725
Country : US
Telephone Number : 732-207-1795
Fax Number :
Provider Business Practice Location Address
First Line : 1446 ETHAN WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-2214
Country : US
Telephone Number : 732-207-1795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2012
Last Update Date : 02/03/2014

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Directions to “ MISS CLEO K ZIFOVSKI CADC II” Practice Location

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