Provider Demographics
NPI:1508248568
Name:ZELAYA, JAIME EDUARDO JR (PHD, MCR)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:EDUARDO
Last Name:ZELAYA
Suffix:JR
Gender:M
Credentials:PHD, MCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7257 N FRESNO ST FL 1
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2950
Mailing Address - Country:US
Mailing Address - Phone:310-869-8662
Mailing Address - Fax:
Practice Address - Street 1:7257 N FRESNO ST FL 1
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2950
Practice Address - Country:US
Practice Address - Phone:310-869-8662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1618062084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program