Healthcare Provider Details

I. General information

NPI: 1700961885
Provider Name (Legal Business Name): MICHELLE MARIETTE ZIRKLE-YOSHIDA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 HIGH ST
SANTA CRUZ CA
95064-1077
US

IV. Provider business mailing address

940 DISC DR
SCOTTS VALLEY CA
95066-4544
US

V. Phone/Fax

Practice location:
  • Phone: 831-594-2500
  • Fax: 831-459-3546
Mailing address:
  • Phone: 831-430-3030
  • Fax: 831-460-6389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15486
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: