Provider Demographics
NPI:1942375811
Name:ZUREK, BEDEANIA RENEE (LCSW 74215)
Entity Type:Individual
Prefix:
First Name:BEDEANIA
Middle Name:RENEE
Last Name:ZUREK
Suffix:
Gender:F
Credentials:LCSW 74215
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 459
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91933-0459
Mailing Address - Country:US
Mailing Address - Phone:619-429-3733
Mailing Address - Fax:619-628-5550
Practice Address - Street 1:949 PALM AVE
Practice Address - Street 2:
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-1503
Practice Address - Country:US
Practice Address - Phone:619-429-3733
Practice Address - Fax:619-628-5550
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA742151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical