Provider Demographics
NPI:1861644288
Name:ZERTUCHE, MARGARITA LUZ
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:LUZ
Last Name:ZERTUCHE
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 1:935 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2349
Mailing Address - Country:US
Mailing Address - Phone:760-482-4768
Mailing Address - Fax:
Practice Address - Street 1:935 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2349
Practice Address - Country:US
Practice Address - Phone:760-482-4768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator