Provider Demographics
NPI:1093201998
Name:ZIERHUT, MATTHAIS ALEXANDER
Entity Type:Individual
Prefix:
First Name:MATTHAIS
Middle Name:ALEXANDER
Last Name:ZIERHUT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NATOMA ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3012
Mailing Address - Country:US
Mailing Address - Phone:916-947-6255
Mailing Address - Fax:
Practice Address - Street 1:801 NATOMA ST
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3012
Practice Address - Country:US
Practice Address - Phone:916-947-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician