Provider Demographics
NPI:1194847764
Name:ZISHKA, RONALD LOUIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LOUIS
Last Name:ZISHKA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 N EUCLID ST
Mailing Address - Street 2:SUITE #108
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4133
Mailing Address - Country:US
Mailing Address - Phone:714-758-1884
Mailing Address - Fax:714-758-3940
Practice Address - Street 1:760 N EUCLID ST
Practice Address - Street 2:SUITE #108
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4133
Practice Address - Country:US
Practice Address - Phone:714-758-1884
Practice Address - Fax:714-758-3940
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14433106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist