Provider Demographics
NPI:1700594769
Name:ZAVALA, SONIA ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:ELIZABETH
Last Name:ZAVALA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:ELIZABETH
Other - Last Name:ZAVALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:31500 GRAPE ST STE 3-286
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-9709
Mailing Address - Country:US
Mailing Address - Phone:714-600-8803
Mailing Address - Fax:
Practice Address - Street 1:960 E GREEN ST STE L-80
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2442
Practice Address - Country:US
Practice Address - Phone:626-793-1179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95192644163W00000X
CAHA8871237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No163W00000XNursing Service ProvidersRegistered Nurse