Provider Demographics
NPI:1982911780
Name:ROSE ZAYCO, PSY.D. INC.
Entity Type:Organization
Organization Name:ROSE ZAYCO, PSY.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAYCO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:904-351-8136
Mailing Address - Street 1:2523 HERSCHEL ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4509
Mailing Address - Country:US
Mailing Address - Phone:904-351-8136
Mailing Address - Fax:888-972-6788
Practice Address - Street 1:2523 HERSCHEL ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204
Practice Address - Country:US
Practice Address - Phone:904-351-8136
Practice Address - Fax:888-972-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8136103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty