Provider Demographics
NPI:1649539875
Name:ZENICK, LYNN HUMFREVILLE
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:HUMFREVILLE
Last Name:ZENICK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VADNA
Other - Middle Name:LYNN
Other - Last Name:HUMFREVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASW
Mailing Address - Street 1:1738 S TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5309
Mailing Address - Country:US
Mailing Address - Phone:760-439-2800
Mailing Address - Fax:760-433-5031
Practice Address - Street 1:1738 S TREMONT ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5309
Practice Address - Country:US
Practice Address - Phone:760-439-2800
Practice Address - Fax:760-433-5031
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health