Basic Information
Provider Information
NPI: 1265196406
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZAPATA
FirstName: MONICA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124724357
FaxNumber: 5127031394
Practice Location
Address1: 1631 E 2ND ST STE A
Address2:  
City: AUSTIN
State: TX
PostalCode: 787024491
CountryCode: US
TelephoneNumber: 5128043380
FaxNumber: 5124725857
Other Information
ProviderEnumerationDate: 10/25/2021
LastUpdateDate: 10/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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