Provider Demographics
NPI:1235597402
Name:ZONA C. LAI PH.D CORPORATION
Entity Type:Organization
Organization Name:ZONA C. LAI PH.D CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZONA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-551-8360
Mailing Address - Street 1:2037 TORREY PINES RD
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-3309
Mailing Address - Country:US
Mailing Address - Phone:858-551-8360
Mailing Address - Fax:
Practice Address - Street 1:2037 TORREY PINES RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-3309
Practice Address - Country:US
Practice Address - Phone:858-551-8360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15697103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty