Healthcare Provider Details

I. General information

NPI: 1245152719
Provider Name (Legal Business Name): LA CURA COLLECTIVE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 BARBEE CT
MARINA CA
93933-5003
US

IV. Provider business mailing address

3400 COTTAGE WAY
SACRAMENTO CA
95825-1474
US

V. Phone/Fax

Practice location:
  • Phone: 831-292-8328
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YEFRY SAMAEL MATA DIAZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 831-292-8328