Healthcare Provider Details

I. General information

NPI: 1386789212
Provider Name (Legal Business Name): JOHANNA MIEKE MOLNAR PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOHANNA MOLNAR WARCHOLA PH.D.

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 DUBOIS ST STE A
SANTA CRUZ CA
95060-2109
US

IV. Provider business mailing address

120 DUBOIS ST STE A
SANTA CRUZ CA
95060-2109
US

V. Phone/Fax

Practice location:
  • Phone: 831-588-0659
  • Fax:
Mailing address:
  • Phone: 831-588-0659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY22211
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: