MILAN DOUGLAS ZYDOW
NPI 1174080139
Counselor - Mental Health in Kensington, CA
Active since February 26, 2019
About Milan Douglas Zydow NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MILAN DOUGLAS ZYDOW (NPI 1174080139) is an individual mental health provider in Kensington, California, licensed in California (40579) and active in the NPI registry since February 2019.
NPPES Registry Identity
NPI1174080139
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMILAN DOUGLAS ZYDOW
Location Address376 COLUSA AVEKensington, CA 94707-1213
Mailing Address376 Colusa AveKensington, CA 94707-1213 · (510) 816-6258
Phone(510) 816-6258
Sole ProprietorYes
Enumeration DateFebruary 26, 2019
Last NPPES UpdateNovember 29, 20212 updates tracked since enumeration
NPPES CertifiedNovember 29, 2021
✔ NPI 1174080139 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CA · 40579
376 COLUSA AVE, Kensington, CA 94707
Group Practice 1
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174080139, enumerated as an "individual" on February 26, 2019.
The provider is located at 376 COLUSA AVE KENSINGTON, CA 94707 and the phone number is (510) 816-6258.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
