Provider Demographics
NPI:1417207473
Name:ZEPEDA, HUMBERTO CHRISTOPHER (CASE MANAGER I)
Entity Type:Individual
Prefix:
First Name:HUMBERTO
Middle Name:CHRISTOPHER
Last Name:ZEPEDA
Suffix:
Gender:M
Credentials:CASE MANAGER I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 W PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3472
Mailing Address - Country:US
Mailing Address - Phone:559-784-0312
Mailing Address - Fax:559-784-5827
Practice Address - Street 1:216 W PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3472
Practice Address - Country:US
Practice Address - Phone:559-784-0312
Practice Address - Fax:559-784-5827
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health