Individual
AXEL ZIJDERVELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6302 THIRTEENTH AVE, LUCERNE, CA 95458
(707) 274-9101
Mailing address
PO BOX 1024, LUCERNE, CA 95458-1024
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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