MEDICARE: MS. KAREN M HUTH MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFT32879	CA

General Provider Information

NPI Number	:	1639281371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN M HUTH MFT

Provider Business Mailing Address
First Line	:	248 24TH AVENUE
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-5304
Country	:	US
Telephone Number	:	831-464-2345
Fax Number	:	831-464-3436

Provider Business Practice Location Address
First Line	:	147 RIVER STREET SOUTH
Second Line	:	SUITE 231
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-4556
Country	:	US
Telephone Number	:	831-566-4460
Fax Number	:	831-464-3436

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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