Provider Demographics
NPI:1144813858
Name:ZARAGOZA-CEJA, ITZEL
Entity type:Individual
Prefix:
First Name:ITZEL
Middle Name:
Last Name:ZARAGOZA-CEJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BRIMMER RD
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95341-5451
Mailing Address - Country:US
Mailing Address - Phone:209-753-9883
Mailing Address - Fax:
Practice Address - Street 1:368 E YOSEMITE AVE # 200-G
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-9100
Practice Address - Country:US
Practice Address - Phone:209-753-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician