Provider Demographics
NPI:1669587762
Name:CAPLLONCH, ZORAIDA
Entity type:Individual
Prefix:DR
First Name:ZORAIDA
Middle Name:
Last Name:CAPLLONCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W FOREST MEADOWS ST
Mailing Address - Street 2:APT. 215
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-2902
Mailing Address - Country:US
Mailing Address - Phone:928-774-4292
Mailing Address - Fax:
Practice Address - Street 1:500 NORTH HWY 89
Practice Address - Street 2:BOB STUMP NORTHERN ARIZONA VA MEDICAL CENTER
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86313
Practice Address - Country:US
Practice Address - Phone:180-094-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10922174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist