Individual
JULIE ANN TATOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4170
(831) 454-4663
Mailing address
4350 CLARES ST APT 8, CAPITOLA, CA 95010-2033
(540) 383-4163
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
086166
NY
104100000X
Social Worker
Primary
74735
CA
104100000X
Social Worker
79269
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
79269
PROFESSIONAL LICENSE
CA
01
—
FHC70042F
SANTA CRUZ COUNTY MEDI-CAL GROUP PTAN#
CA
01
—
ZZZ91891Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
Enumeration date
02/26/2013
Last updated
12/08/2017
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