Provider Demographics
NPI:1568651347
Name:ZIZZO, JOSEPH ANTHONY (MA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:ZIZZO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:MR
Other - First Name:J.
Other - Middle Name:ANTHONY
Other - Last Name:ZIZZO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1880 SHASTA ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0417
Mailing Address - Country:US
Mailing Address - Phone:530-248-3047
Mailing Address - Fax:530-248-3098
Practice Address - Street 1:1800 SHASTA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0417
Practice Address - Country:US
Practice Address - Phone:530-248-3000
Practice Address - Fax:530-248-3098
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 54435106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist