Provider Demographics
NPI:1033155569
Name:ZIRPOLO, NICHOLAS J (PH D)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:ZIRPOLO
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4161 EL CAMINO WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4006
Mailing Address - Country:US
Mailing Address - Phone:650-494-1215
Mailing Address - Fax:650-494-7272
Practice Address - Street 1:4161 EL CAMINO WAY
Practice Address - Street 2:SUITE B
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-4006
Practice Address - Country:US
Practice Address - Phone:650-494-1215
Practice Address - Fax:650-494-7272
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11597103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL115970Medicare UPIN