Provider Demographics
NPI:1043451438
Name:ZULIM, REBECCA ELIZABETH (LMFT)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:ZULIM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:ELIZABETH
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 WATER STREET
Mailing Address - Street 2:SUITE E2
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060
Mailing Address - Country:US
Mailing Address - Phone:831-239-7574
Mailing Address - Fax:831-423-1532
Practice Address - Street 1:550 WATER STREET
Practice Address - Street 2:SUITE E2
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060
Practice Address - Country:US
Practice Address - Phone:831-239-7574
Practice Address - Fax:831-423-1532
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 57496101YS0200X
CA53774106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF 57496OtherIMF