Juan Rafael Zavala, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301014144 Issued in MI

Practice address

79 W Alexandrine St
Detroit, MI 48201

Phone

(313) 831-5535

Fax

(313) 831-2608

NPI assigned

Aug 11, 2014

Last updated

Jun 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529193600000",
    "number": "1528477908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012015",
            "telephone_number": "313-831-5535",
            "fax_number": "313-831-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 W ALEXANDRINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-831-5535",
            "fax_number": "313-831-2608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Waterman St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482092022",
            "country_code": "US",
            "telephone_number": "313-841-8900 x2425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "JUAN",
        "middle_name": "RAFAEL",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-11",
        "last_updated": "2018-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard J. Zarbo, M.D.
• Parinaz Zaree Bavani
• Natalie Frontera Zarek, RN
• Caitlin Zatkoff
• Zatoriah Community Care, LLC
• Barbara Zavislak, CRNA
• John Raymond Zawacki, PAC
• Jenin Zayad
• Pierre A Zayat, M.D.
• Zcare

• Clinical Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2018; 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.