Healthcare Provider Details

I. General information

NPI: 1730207200
Provider Name (Legal Business Name): CLAIRE ZURACK MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 LOS GAMOS DR SUITE 200
SAN RAFAEL CA
94903-1809
US

IV. Provider business mailing address

11A WARNER CT
SAN RAFAEL CA
94901-3902
US

V. Phone/Fax

Practice location:
  • Phone: 415-457-1925
  • Fax: 415-457-1929
Mailing address:
  • Phone: 415-457-1925
  • Fax: 415-457-1929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT31010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: