Provider Demographics
NPI:1710762836
Name:ZARIAH N. RICOSSA, LCSW
Entity Type:Organization
Organization Name:ZARIAH N. RICOSSA, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZARIAH
Authorized Official - Middle Name:N
Authorized Official - Last Name:RICOSSA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:760-456-9326
Mailing Address - Street 1:1106 2ND ST STE 856
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5008
Mailing Address - Country:US
Mailing Address - Phone:760-456-9326
Mailing Address - Fax:760-800-4099
Practice Address - Street 1:3459 MANCHESTER AVE, #25
Practice Address - Street 2:
Practice Address - City:CARDIFF
Practice Address - State:CA
Practice Address - Zip Code:92007
Practice Address - Country:US
Practice Address - Phone:760-456-9326
Practice Address - Fax:760-800-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)