Individual
JACOB ADAM ZAVALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4890
Mailing address
1153 ASH ST STE B, ARROYO GRANDE, CA 93420-3844
(805) 458-3659
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41575
CA
Other
Enumeration date
03/26/2020
Last updated
05/14/2020
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