Provider Demographics
NPI:1164723789
Name:ZATYKO, JILL LOUISE (LMFT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:LOUISE
Last Name:ZATYKO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9049 CALLE LUCIA
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-5002
Mailing Address - Country:US
Mailing Address - Phone:619-375-4666
Mailing Address - Fax:619-369-4535
Practice Address - Street 1:9049 CALLE LUCIA
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040-5002
Practice Address - Country:US
Practice Address - Phone:619-375-4666
Practice Address - Fax:619-369-4535
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health