Basic Information
| Provider Information | |||||||||
| NPI: | 1417059510 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAPATA | ||||||||
| FirstName: | JONI | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18406 ROSCOE BLVD | ||||||||
| Address2: | |||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913254107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188855480 | ||||||||
| FaxNumber: | 8188853515 | ||||||||
| Practice Location | |||||||||
| Address1: | 18406 ROSCOE BLVD | ||||||||
| Address2: | NORTHRIDGE FAMILY PRACTICE MEDICAL GROUP | ||||||||
| City: | NORTHRIDGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913254107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188855480 | ||||||||
| FaxNumber: | 8188853515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 11/30/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | C50671 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00C506710 | 05 | CA | MEDICAID |