Individual
MIRANDA GAYLE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 HARVEY WEST BLVD, SANTA CRUZ, CA 95060-2103
(831) 425-8132
Mailing address
1740 17TH AVE, SANTA CRUZ, CA 95062-1804
(831) 427-5070
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21878
CA
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
CA
372600000X
Adult Companion
—
—
Other
Enumeration date
05/31/2024
Last updated
03/09/2026
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