Healthcare Provider Details

I. General information

NPI: 1447389036
Provider Name (Legal Business Name): SHAINA KATE ZURA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 EMELINE AVE
SANTA CRUZ CA
95060-1976
US

IV. Provider business mailing address

1400 EMELINE AVE.
SANTA CRUZ CA
95062
US

V. Phone/Fax

Practice location:
  • Phone: 831-454-4170
  • Fax: 831-454-4663
Mailing address:
  • Phone: 831-454-4170
  • Fax: 831-454-4663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number59904
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: