Provider Demographics
NPI:1366479131
Name:ZUDIKER, STEVEN N (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:N
Last Name:ZUDIKER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4486 BANCROFT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4567
Mailing Address - Country:US
Mailing Address - Phone:619-370-2956
Mailing Address - Fax:
Practice Address - Street 1:8760 CUYAMACA ST
Practice Address - Street 2:211
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-6210
Practice Address - Country:US
Practice Address - Phone:619-596-9892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19051103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP19051Medicare ID - Type Unspecified