Healthcare Provider Details

I. General information

NPI: 1801060868
Provider Name (Legal Business Name): JULIE A ZEISE CAADAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2008
Last Update Date: 04/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 41ST AVE
SANTA CRUZ CA
95062-4400
US

IV. Provider business mailing address

1051 41ST AVE
SANTA CRUZ CA
95062-4400
US

V. Phone/Fax

Practice location:
  • Phone: 831-476-1747
  • Fax:
Mailing address:
  • Phone: 831-473-1747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: