Provider Demographics
NPI:1609660943
Name:VALLEJO, ZACHARY ROBERT
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:ROBERT
Last Name:VALLEJO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 S CENTRAL ST STE C&D
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-4417
Mailing Address - Country:US
Mailing Address - Phone:559-668-3194
Mailing Address - Fax:
Practice Address - Street 1:1820 S CENTRAL ST STE C&D
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4417
Practice Address - Country:US
Practice Address - Phone:559-668-3194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator