Provider Demographics
NPI:1770709560
Name:MARISCAL ZARAGOZA, XOCHITLQUETZAL MARISCAL
Entity type:Individual
Prefix:
First Name:XOCHITLQUETZAL
Middle Name:MARISCAL
Last Name:MARISCAL ZARAGOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:XOCHITL
Other - Middle Name:MARISCAL
Other - Last Name:ZARAGOZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:241 E LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-4717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 E LAKE AVE
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-4717
Practice Address - Country:US
Practice Address - Phone:831-728-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor