Zenaida Leano Suzara

Individual provider Active NPI Licensed Psychiatric Technician · Stockton, CA

NPI 1124242979 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124242979
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Psychiatric Technician 167G00000X
License
PT32630 (CA)
Practice address
1212 N California St
Stockton, CA 95202-1552
Phone
(209) 468-8660
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT32630CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X PT32630 CA Yes

Addresses

Primary practice location

1212 N California St
Stockton, CA 95202-1552

Mailing address

227 Woodstock Dr
Stockton, CA 95207-5829

Other providers in Stockton, CA

All providers in Stockton, CA · Licensed Psychiatric Technician in California

Sources for this page

Verify at the official NPI Registry.