Provider Demographics
NPI:1497305700
Name:HERNANDEZ-ZARATE, ANAMAURI
Entity Type:Individual
Prefix:
First Name:ANAMAURI
Middle Name:
Last Name:HERNANDEZ-ZARATE
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 1:306 S SULLIVAN ST SPC 35
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-1646
Mailing Address - Country:US
Mailing Address - Phone:714-631-3435
Mailing Address - Fax:
Practice Address - Street 1:17861 VON KARMAN AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6213
Practice Address - Country:US
Practice Address - Phone:951-365-3840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst