Provider Demographics
NPI:1841627007
Name:ZAMUDIO, JANET
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:ZAMUDIO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:925 LOUGHBOROUGH DR
Mailing Address - Street 2:212
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2307
Mailing Address - Country:US
Mailing Address - Phone:209-627-9213
Mailing Address - Fax:
Practice Address - Street 1:925 LOUGHBOROUGH DR
Practice Address - Street 2:212
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2307
Practice Address - Country:US
Practice Address - Phone:209-627-9213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAXXXXXXMedicare UPIN