Provider Demographics
NPI:1700242450
Name:ZENDEJAS, VIRIDIANA (LCSW)
Entity Type:Individual
Prefix:
First Name:VIRIDIANA
Middle Name:
Last Name:ZENDEJAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W WESTERN AVE UNIT 458
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-4419
Mailing Address - Country:US
Mailing Address - Phone:602-575-6335
Mailing Address - Fax:
Practice Address - Street 1:2614 S 119TH DR
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-7652
Practice Address - Country:US
Practice Address - Phone:602-575-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9433420-35021041C0700X
UT9433420-35011041C0700X
AZLCSW-172981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical