MEDICARE: MRS. MARISA ABZUG M.A., LMFT

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	MFC 44812	CA

General Provider Information

NPI Number	:	1871616383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARISA ABZUG M.A., LMFT

Provider Business Mailing Address
First Line	:	151 ANDREA LN
Second Line	:
City	:	FELTON
State	:	CA
Zip	:	95018-9605
Country	:	US
Telephone Number	:	831-704-6775
Fax Number	:	877-878-2808

Provider Business Practice Location Address
First Line	:	730 MISSION ST STE 202
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-3689
Country	:	US
Telephone Number	:	831-704-6775
Fax Number	:	877-878-2808

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	05/11/2026

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