Provider Demographics
NPI:1881455319
Name:ZAVALETTA, PETER MICHAEL II (PCS)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:MICHAEL
Last Name:ZAVALETTA
Suffix:II
Gender:F
Credentials:PCS
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:ROSALINDA
Other - Last Name:ZAVALETTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NV
Mailing Address - Zip Code:89415-1510
Mailing Address - Country:US
Mailing Address - Phone:775-945-2461
Mailing Address - Fax:775-945-0744
Practice Address - Street 1:200 S A ST
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NV
Practice Address - Zip Code:89415-8941
Practice Address - Country:US
Practice Address - Phone:775-945-2461
Practice Address - Fax:775-945-0744
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker