Provider Demographics
NPI:1861934275
Name:ZUNIGA, MIKAELA (DSW, LMFT)
Entity type:Individual
Prefix:DR
First Name:MIKAELA
Middle Name:
Last Name:ZUNIGA
Suffix:
Gender:F
Credentials:DSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14515 WOODLAND DR UNIT 13
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-0102
Mailing Address - Country:US
Mailing Address - Phone:909-437-4627
Mailing Address - Fax:
Practice Address - Street 1:14515 WOODLAND DR UNIT 13
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-0102
Practice Address - Country:US
Practice Address - Phone:909-437-4627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2025-02-14
Deactivation Date:2025-01-22
Deactivation Code:
Reactivation Date:2025-02-12
Provider Licenses
StateLicense IDTaxonomies
CA117931106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist