Provider Demographics
NPI:1659715712
Name:DUVIELLA, ZAKIYA STARR
Entity Type:Individual
Prefix:MS
First Name:ZAKIYA
Middle Name:STARR
Last Name:DUVIELLA
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 1:1020 S SANTA FE AVE
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-7000
Mailing Address - Country:US
Mailing Address - Phone:760-305-8225
Mailing Address - Fax:760-305-8232
Practice Address - Street 1:1020 S SANTA FE AVENUE
Practice Address - Street 2:SUITE B-1
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-7000
Practice Address - Country:US
Practice Address - Phone:760-305-8225
Practice Address - Fax:760-305-8232
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF80376106H00000X
CALMFT 97165106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program