Provider Demographics
NPI:1679780209
Name:ZARATE, MICHELLE ROSE (CAS II)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ROSE
Last Name:ZARATE
Suffix:
Gender:F
Credentials:CAS II
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ROSE
Other - Last Name:PINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1425 E WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-1415
Mailing Address - Country:US
Mailing Address - Phone:559-625-4072
Mailing Address - Fax:559-625-4729
Practice Address - Street 1:705 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-2727
Practice Address - Country:US
Practice Address - Phone:559-635-8010
Practice Address - Fax:559-635-1411
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA02-001154101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)