Provider Demographics
NPI:1679158687
Name:ZHOU, VIVIAN
Entity type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:
Last Name:ZHOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:ZHOU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACSW
Mailing Address - Street 1:3500 IOWA AVE # A211A
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-7208
Mailing Address - Country:US
Mailing Address - Phone:415-990-1829
Mailing Address - Fax:
Practice Address - Street 1:6800 INDIANA AVE STE 260
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4287
Practice Address - Country:US
Practice Address - Phone:951-782-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW892601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical