Individual
CONSUELO CHAVARRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 LOCUST ST, SANTA CRUZ, CA 95060-3813
(831) 427-3600
(831) 457-2486
Mailing address
250 LOCUST ST, SANTA CRUZ, CA 95060-3813
(831) 427-3600
(831) 457-2486
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902923329
—
CA
Enumeration date
05/31/2016
Last updated
05/31/2016
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