Provider Demographics
NPI:1316143159
Name:FLUHART NEGRETE, KARUNA
Entity type:Individual
Prefix:
First Name:KARUNA
Middle Name:
Last Name:FLUHART NEGRETE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:KARUNA
Other - Last Name:FLUHART NEGRETE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7325
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95061-7325
Mailing Address - Country:US
Mailing Address - Phone:831-535-8693
Mailing Address - Fax:
Practice Address - Street 1:157 VAN NESS AVE
Practice Address - Street 2:#1
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4200
Practice Address - Country:US
Practice Address - Phone:831-535-8693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0093311101YM0800X
CA46611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health