Tanya Bateza Zodulua, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121421 Issued in CA

Practice address

302 W 5TH St Unit 102
San Pedro, CA 90731-2738

Phone

(424) 570-6955

NPI assigned

Mar 29, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1114667243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 LIGON CREEK LOOP APT 305",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874780",
            "telephone_number": "818-224-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W 5TH ST UNIT 102",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312738",
            "telephone_number": "424-570-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZODULUA",
        "first_name": "TANYA",
        "middle_name": "BATEZA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://wc-wfe-127.advancedmd.com/",
            "affiliation": "N",
            "address_1": "302 W 5th St Unit 102",
            "city": "San Pedro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907312738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zenithmedicine
• Griselda Zermino, MENTAL HEALTH, LMFT
• Zheng Zhang
• Zeljko Zic, M.D.
• John Zivkovic
• Lisa Judith Zwerling, M.D.

• Clinical Social Worker in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.