Provider Demographics
NPI:1578601480
Name:ZHUKOV, VERA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:VERA
Middle Name:
Last Name:ZHUKOV
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3202
Mailing Address - Country:US
Mailing Address - Phone:951-273-0608
Mailing Address - Fax:951-273-1718
Practice Address - Street 1:1195 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3202
Practice Address - Country:US
Practice Address - Phone:951-273-0608
Practice Address - Fax:951-273-1718
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40826106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist