Provider Demographics
NPI:1659657344
Name:ZAPATA, ARMANDO JESUS (CADC-II A018190315)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:JESUS
Last Name:ZAPATA
Suffix:
Gender:M
Credentials:CADC-II A018190315
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11133 DAYLILLY ST
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-6829
Mailing Address - Country:US
Mailing Address - Phone:190-926-8275
Mailing Address - Fax:
Practice Address - Street 1:658 BRIER ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-3934
Practice Address - Country:US
Practice Address - Phone:909-252-5402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAI9660610101YA0400X
CAA018190315101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)