1881815108 NPI number — HILDA ROJAS ZASUETA PHD PSYCHOLOGIST

Table of content: HILDA ROJAS ZASUETA PHD PSYCHOLOGIST (NPI 1881815108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881815108 NPI number — HILDA ROJAS ZASUETA PHD PSYCHOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZASUETA
Provider First Name:
HILDA
Provider Middle Name:
ROJAS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD PSYCHOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARDER
Provider Other First Name:
HILDA
Provider Other Middle Name:
ROJAS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881815108
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4545 COUNTRY CLUB LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONG BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90807-1432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-426-5615
Provider Business Mailing Address Fax Number:
562-426-5615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4545 COUNTRY CLUB LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90807-1432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-426-5615
Provider Business Practice Location Address Fax Number:
562-426-5615
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY8976 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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