Healthcare Provider Details

I. General information

NPI: 1497214936
Provider Name (Legal Business Name): MARIANA OSUNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 17TH AVE # 1126
SANTA CRUZ CA
95062-1860
US

IV. Provider business mailing address

2460 17TH AVE # 1126
SANTA CRUZ CA
95062-1860
US

V. Phone/Fax

Practice location:
  • Phone: 408-384-8168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number104991
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126353
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number104991
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: