Provider Demographics
NPI:1184905176
Name:ZELLER, NORA CATHERINE ARAGON (MA)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:CATHERINE ARAGON
Last Name:ZELLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:CATHERINE
Other - Last Name:ARAGON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:575 N LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-3303
Mailing Address - Country:US
Mailing Address - Phone:760-470-7002
Mailing Address - Fax:
Practice Address - Street 1:1212 VALENCIA DR
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1798
Practice Address - Country:US
Practice Address - Phone:909-580-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4402525174400000X
CALEP3605103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No174400000XOther Service ProvidersSpecialist