Provider Demographics
NPI:1649722778
Name:MAZZONI, RONIT (MS)
Entity type:Individual
Prefix:MRS
First Name:RONIT
Middle Name:
Last Name:MAZZONI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 CHABRANT WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-2371
Mailing Address - Country:US
Mailing Address - Phone:909-489-7255
Mailing Address - Fax:
Practice Address - Street 1:927 CHABRANT WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-2371
Practice Address - Country:US
Practice Address - Phone:909-489-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000135170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS