Healthcare Provider Details

I. General information

NPI: 1821907627
Provider Name (Legal Business Name): PEARL CHAIYARAT, LICENSED MARRIAGE AND FAMILY THERAPIST, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 MISSION ST STE 202
SANTA CRUZ CA
95060-3689
US

IV. Provider business mailing address

PO BOX 106
FELTON CA
95018-0106
US

V. Phone/Fax

Practice location:
  • Phone: 831-454-1702
  • Fax:
Mailing address:
  • Phone: 831-454-1702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: PEARL CHAIYARAT
Title or Position: EMPLOYER/EMPLOYEE
Credential: LMFT
Phone: 831-227-1605