Provider Demographics
NPI:1831677905
Name:ZHANG, JIAYUAN
Entity Type:Individual
Prefix:
First Name:JIAYUAN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 MARIN BLVD APT 619
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1788
Mailing Address - Country:US
Mailing Address - Phone:929-341-7570
Mailing Address - Fax:
Practice Address - Street 1:485 MARIN BLVD APT 619
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-1788
Practice Address - Country:US
Practice Address - Phone:929-341-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor