Organization
KIDANGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LILIAN PATRICIA ZELAYA MSW (MENTAL HEALTH CLINICIAN)
(707) 921-9232
Entity
Organization
Contact information
Practice address
44000 OLD WARM SPRINGS BLVD, FREMONT, CA 94538-6145
(510) 897-6900
Mailing address
44000 OLD WARM SPRINGS BLVD, FREMONT, CA 94538-6145
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
30172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30172
BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
05/02/2011
Last updated
05/02/2011
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