Provider Demographics
NPI:1720543085
Name:ZELADA, ROLANDO A I
Entity Type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:A
Last Name:ZELADA
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 N ARGONNE AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-3003
Mailing Address - Country:US
Mailing Address - Phone:703-628-6832
Mailing Address - Fax:
Practice Address - Street 1:406 N ARGONNE AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-3003
Practice Address - Country:US
Practice Address - Phone:703-628-6832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT65358621106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst