Individual
JUDY MIRAMONTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RTC
Contact information
Practice address
380 ENCINAL ST STE 200, SANTA CRUZ, CA 95060-2178
(831) 469-1700
Mailing address
380 ENCINAL ST STE 200, SANTA CRUZ, CA 95060-2178
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
5124-T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5124-T
RECREATION THERAPY CERTIFIED
CA
Enumeration date
04/02/2020
Last updated
04/02/2020
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