Provider Demographics
NPI:1720752280
Name:ZUNIGA FLORES, RICARDO ALEXIS
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:ALEXIS
Last Name:ZUNIGA FLORES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11233 BORDEN AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-1506
Mailing Address - Country:US
Mailing Address - Phone:818-405-2631
Mailing Address - Fax:
Practice Address - Street 1:1605 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3808
Practice Address - Country:US
Practice Address - Phone:323-433-4165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst