Provider Demographics
NPI:1467583864
Name:XICOTENCATL, ZUELIKA CRISTINA
Entity Type:Individual
Prefix:MRS
First Name:ZUELIKA
Middle Name:CRISTINA
Last Name:XICOTENCATL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-1003
Mailing Address - Country:US
Mailing Address - Phone:909-387-7378
Mailing Address - Fax:909-387-7386
Practice Address - Street 1:900 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-1004
Practice Address - Country:US
Practice Address - Phone:909-387-6942
Practice Address - Fax:909-386-0750
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical