Provider Demographics
NPI:1912122672
Name:MERRITHEW, RAYMOND
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:MERRITHEW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 FRONT ST
Mailing Address - Street 2:130
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4535
Mailing Address - Country:US
Mailing Address - Phone:831-423-2003
Mailing Address - Fax:
Practice Address - Street 1:740 FRONT ST
Practice Address - Street 2:130
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4535
Practice Address - Country:US
Practice Address - Phone:831-423-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist