Provider Demographics
NPI:1376131839
Name:ZAVALETA, HOLLY CHRISTINE (CPHT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:CHRISTINE
Last Name:ZAVALETA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 FEATHER DR PMB 35
Mailing Address - Street 2:
Mailing Address - City:COPPEROPOLIS
Mailing Address - State:CA
Mailing Address - Zip Code:95228
Mailing Address - Country:US
Mailing Address - Phone:209-817-4298
Mailing Address - Fax:
Practice Address - Street 1:1291 SANGUINETTI RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-6215
Practice Address - Country:US
Practice Address - Phone:209-533-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician