Provider Demographics
NPI:1508687567
Name:ZAPATA, JOHN ANTHONY (CAPRC, CPSP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:ZAPATA
Suffix:
Gender:M
Credentials:CAPRC, CPSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6774 RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-2592
Mailing Address - Country:US
Mailing Address - Phone:219-689-2153
Mailing Address - Fax:
Practice Address - Street 1:6774 RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-2592
Practice Address - Country:US
Practice Address - Phone:219-939-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCAPRC1-5741175T00000X
IN4156175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist