Individual
CHELSEY SUTTABY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4170
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4170
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW71329
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ91891Z
MEDICARE GROUP SITE PTAN@ IN SANTA CRUZ COUNTY CA
CA
01
—
ZZZ91892Z
MEDICARE GROUP SITE PTAN@ IN SANTA CRUZ COUNTY CA
CA
01
—
ZZZ92069Z
MEDICARE GROUP SITE PTAN@ IN SANTA CRUZ COUNTY CA
CA
Enumeration date
09/14/2011
Last updated
06/16/2017
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