Provider Demographics
NPI:1558643023
Name:ZAKARYAN, JILL MARIE (ACSW)
Entity Type:Individual
Prefix:MISS
First Name:JILL
Middle Name:MARIE
Last Name:ZAKARYAN
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 N PARKER ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-1323
Mailing Address - Country:US
Mailing Address - Phone:714-639-5546
Mailing Address - Fax:714-639-5037
Practice Address - Street 1:525 N PARKER ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1323
Practice Address - Country:US
Practice Address - Phone:714-639-5546
Practice Address - Fax:714-639-5037
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84740101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)