| Doctor Name: | DR. MARK RICHARD ZASLAV |
| NPI Number: | 1255486270 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PSY 9205 |
| Business Practice Address: | 21 Tamal Vista Blvd Ste 120 Corte Madera, CA - 949251140 |
| Business Phone Number: | 4159271560 |
| Business Fax Number: | |
| Mailing Address: | 2 Glen Way, LARKSPUR |
| State: | CA |
| Postal Code: | 949391904 |
| Phone Number: | 4159271560 |
| Fax Number: | |
| NPI Enumeration Date: | 01/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | PSY 9205 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |