Provider Demographics
NPI:1417019142
Name:ZAZULA, ROBERT H (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:H
Last Name:ZAZULA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 MCCOY CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-3784
Mailing Address - Country:US
Mailing Address - Phone:707-330-7439
Mailing Address - Fax:
Practice Address - Street 1:740 BECK AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4440
Practice Address - Country:US
Practice Address - Phone:707-784-6570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS145941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical