Provider Demographics
NPI:1891553723
Name:ZAVALA, AARON BENJAMIN
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:BENJAMIN
Last Name:ZAVALA
Suffix:
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 1:138 FORSITHIA LN
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-4333
Mailing Address - Country:US
Mailing Address - Phone:760-500-7038
Mailing Address - Fax:
Practice Address - Street 1:138 FORSITHIA LN
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-4333
Practice Address - Country:US
Practice Address - Phone:760-500-7038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician