Provider Demographics
NPI:1598326225
Name:ZAHARIA, KYLE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:ZAHARIA
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 1:1901 NEWPORT BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2299
Mailing Address - Country:US
Mailing Address - Phone:949-242-9720
Mailing Address - Fax:
Practice Address - Street 1:1901 NEWPORT BLVD STE 350
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2299
Practice Address - Country:US
Practice Address - Phone:949-242-9720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health