Organization
RIDE THE WAVE RECOVERY: PROFESSIONAL CLINICAL COUNSELOR PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE M ZWICK LPCC (EXECUTIVE DIRECTOR)
(831) 275-5481
Entity
Organization
Contact information
Practice address
104 WALNUT AVE STE 200, SANTA CRUZ, CA 95060-3929
(831) 275-5481
Mailing address
104 WALNUT AVE STE 200, SANTA CRUZ, CA 95060-3929
(831) 275-5481
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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