Provider Demographics
NPI:1336747559
Name:ZAMBRANO, JAEL ARELI
Entity Type:Individual
Prefix:MRS
First Name:JAEL
Middle Name:ARELI
Last Name:ZAMBRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JAEL
Other - Middle Name:ARELI
Other - Last Name:ESQUEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3801
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92244-3801
Mailing Address - Country:US
Mailing Address - Phone:760-791-2458
Mailing Address - Fax:
Practice Address - Street 1:495 E ORANGE AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2744
Practice Address - Country:US
Practice Address - Phone:760-353-6151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225C00000X
CAAMFT136426106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor