Healthcare Provider Details

I. General information

NPI: 1073166328
Provider Name (Legal Business Name): MRS. LAINA CATHERINE JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 FREDERICK ST
SANTA CRUZ CA
95062-2239
US

IV. Provider business mailing address

727 ALMAR AVE
SANTA CRUZ CA
95060-5845
US

V. Phone/Fax

Practice location:
  • Phone: 831-316-4943
  • Fax:
Mailing address:
  • Phone: 831-316-4943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number114210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: