Healthcare Provider Details

I. General information

NPI: 1023818234
Provider Name (Legal Business Name): CATARINA AHLVIK-GARRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 FREDERICK ST
SANTA CRUZ CA
95062-2239
US

IV. Provider business mailing address

640 PAU HANA DR
SOQUEL CA
95073-9691
US

V. Phone/Fax

Practice location:
  • Phone: 831-288-5234
  • Fax:
Mailing address:
  • Phone: 650-398-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC18936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: