Provider Demographics
NPI:1760673065
Name:HORTON, ZARIAH TIFFANY ELISE (MFT)
Entity Type:Individual
Prefix:MS
First Name:ZARIAH
Middle Name:TIFFANY ELISE
Last Name:HORTON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:ZARIA
Other - Middle Name:ELISE
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:100 W WALNUT ST STE 375
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91124-0001
Mailing Address - Country:US
Mailing Address - Phone:626-395-7100
Mailing Address - Fax:
Practice Address - Street 1:100 W WALNUT ST STE 375
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91124-0001
Practice Address - Country:US
Practice Address - Phone:626-395-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF78991101YM0800X
172V00000X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty