Provider Demographics
NPI:1336348671
Name:MOUNT, ZOE ULANTHA (MFT)
Entity Type:Individual
Prefix:MS
First Name:ZOE
Middle Name:ULANTHA
Last Name:MOUNT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:ZOE
Other - Middle Name:ULANTHA
Other - Last Name:GARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:201 SAN ANTONIO CIR
Mailing Address - Street 2:#125
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1254
Mailing Address - Country:US
Mailing Address - Phone:650-996-6042
Mailing Address - Fax:
Practice Address - Street 1:201 SAN ANTONIO CIR
Practice Address - Street 2:#125
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-1254
Practice Address - Country:US
Practice Address - Phone:650-996-6042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40558106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist