Provider Demographics
NPI:1568011310
Name:DZURISIN, MARGARET M
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:DZURISIN
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 1:313 PLAZA DR STE A7
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6931
Mailing Address - Country:US
Mailing Address - Phone:815-326-5666
Mailing Address - Fax:
Practice Address - Street 1:313 PLAZA DR STE A7
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6931
Practice Address - Country:US
Practice Address - Phone:815-326-5666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician