Provider Demographics
NPI:1790811248
Name:ZARATE, ROBERTO (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:
Last Name:ZARATE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91102-0247
Mailing Address - Country:US
Mailing Address - Phone:626-405-4001
Mailing Address - Fax:818-301-7443
Practice Address - Street 1:751 N FAIR OAKS AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3069
Practice Address - Country:US
Practice Address - Phone:626-405-4001
Practice Address - Fax:818-301-7443
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26446103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical